SURGICAL TACTICS FOR CHOLELITHIASIS WITH COMPLICATIONS OBSTRUCTIVE JAUNDICE
Keywords:
endoscopic retrograde intervention, mechanical jaundice, cholecystectomy, drainage of biliary, mini-laparotomyAbstract
The purpose of the work: Comparative analysis of the use of different methods of biliary compression in patients with mechanical jaundice, a complication of gallstone disease.
Materials and methods: We analysed 116 patients who were treated for cholelithiasis complicated by mechanical jaundice between years 2020 and 2023 in the Samarkand city medical association.
As supporters, treatment for mechanical jaundice, we carried out decompression and sanitation biliary tract. This was done by using of retrograde endoscopic method.
Results. Endoscopic papillosphincterotomy carried out in 68 patients (58,6%). Choledocholithoextraction performed in 39 patients (57,3%). The indication for drainage were: multiple choledocholithiasis, the lack of confidence in an adequate sanitation of hepaticocholedochus and cholangitis. Repeated control retrograde interventions was performed in quarter of them, technically in 29 patients. After restoration of passage of bile and the elimination of jaundice mini-access managed cholecystectomy was carried out in 54 patients.
Mini-laparotomy of cholecystectomy and drainage of choledoch through the stump cystic duct was performed in 14 patients. In 48 patients, it was revealed that was impossible to perform endoscopic interventions due to difficulties of catheterization of BDC .
Conclusions. We believe that, using two-staged minimally invasive treatment is optimal approach for obstructive jaundice. We consider if it is impossible to drainage bile ducts, external and internal drainage of the common bile duct is necessary to restore the continuous passages of bile into the intestines by laparotomy method.
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Статья поступила в редакцию 15.01.2024; одобрена после рецензирования 18.02.2024; принята к публикации 20.02.2024.
The article was submitted 15.01.2024; approved after reviewing 18.02.2024; accepted for publication 20.02.2024.
Информация об авторах:
Бабажанов Ахмаджон Султанбаевич – д.м.н., профессор, Зав. кафедрой хирургических болезней педиатрического факультета Самаркандский государственный медицинский университет, Самарканд, Узбекистан. Е-mail: axmadjon.babajanov@mail.ru, https://orcid.org/0009-0007-5214-6895
Абдурахманов Эшонкул Мавутович – врач ординатор Самаркандского городского медицинского обеъдинения. Самарканд, Узбекистан. E-mail: dr.eshonkul@mail.ru https://orcid.org/0009-0005-8662-1880
Ахмедов Адхам Ибадуллаевич- PhD, и.о. доцент, кафедра хирургических болезней педиатрического факультета Самаркандский государственный медицинский университет, Самарканд, Узбекистан. Е-mail: aiaxmedov@mail.ru, https://orcid.org/0000-0002-2389-6247
Источники финансирования: Работа не имела специального финансирования.
Конфликт интересов: Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи.
Вклад авторов:
Бабажанов А.С..— Идеологическая концепция работы, редактирование статьи
Абдурахманов Э.М. — Разработка концепции и дизайна исследования
Ахмедов А.И. —Сбор и анализ источников литературы, написание текста
Information about the authors:
Babazhanov Akhmadzhon Sultanbaevich – Doctor of Medical Sciences, Professor, Head of the Department of Surgical Diseases, Faculty of Pediatrics, Samarkand State Medical University, Samarkand, Uzbekistan. Е-mail: axmadjon.babajanov@mail.ru, https://orcid.org/0009-0007-5214-6895
Abdurakhmanov Eshonkul Mavutovich Resident doctor at Samarkand City Medical Association Samarkand, Uzbekistan. E-mail: dr.eshonkul@mail.ru https://orcid.org/0009-0005-8662-1880
Ахмедов Адхам Ибадуллаевич- PhD, и.о. доцент, кафедра хирургических болезней педиатрического факультета Самаркандский государственный медицинский университет, Самарканд, Узбекистан. Е-mail: aiaxmedov@mail.ru, https://orcid.org/0000-0002-2389-6247
Sources of funding: The work did not receive any specific funding.
Conflict of interest: The authors declare no explicit or potential conflicts of interest associated with the publication of this article.
Authors' contributions:
Babazhanov A.S.—Ideological concept of the work, editing the article
Abdurakhmanov E.M. — Development of the concept and design of the study
Akhmedov A.I. —Collection and analysis of literature sources, writing text
