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Khirurgii

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Year 2011 Vol. 19 No 4

GENERAL AND SPECIAL SURGERY

F.G. NAZYROV, L.P. STRUSSKY, A.V. DEVYATOV, A.H. BABADZHANOV, D.A. DZHUMANIYAZOV

RESULTS OF ENDOSCOPIC INTERVENTIONS IN PATIENTS WITH CHOLELITHISASIS COMPLICATED BY MECHANICAL JAUNDICE

Objectives. To analyze the results of therapeutic-diagnostic endoscopic interventions in the group of patients with cholelithiasis complicated by a mechanical jaundice.
Methods. Comparative analysis of the results of endoscopic interventions was performed in 427 patients with cholelithiasis, complicated by a mechanical jaundice. ERCP and endoscopic interventions; papillosphincterotomy or suprapapillar choledochoduodenostomy were carried out.
Results. Endoscopic manipulations are of high diagnostic (93,5%) and therapeutic (78%) efficacy. The performance of atypical endoscopic papillotomy interventions causes the increase of risk in specific complications development; the hemorrhage frequency composed 12,5% in comparison with 6, 8% at EPST; and provoked ERCP of acute pancreatitus – 7,7% and 5% correspondently. Inefficacy of the conservative actions concerning complications after endoscopic interventions demanded an urgent surgery in 6 (15, 8%) patients after EPST and in 7 (31, 8%) patients after SPCDS.
Conclusions. The endoscopic procedures are highly effective methods for diagnosis and minimally invasive treatment of patients with cholelithiasis complicated by a mechanical jaundice. However, one needs a rational approach taking into account possible risk factors for development of complications specific for this type of interventions.

Keywords: cholelithiasis, mechanical jaundice, endoscopic interventions, papillosphincterotomy, choledochoduodenotomy
p. 36 – 41 of the original issue
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