ТЕРАПЕВТИЧЕСКОЕ ПРИМЕНЕНИЕ МАЛОИНВАЗИВНЫХ ДЕКОМПРЕССИОННЫХ ПРОЦЕДУР В ХИРУРГИЧЕСКОМ ЛЕЧЕНИИ ХОЛАНГИТА
Ключевые слова:
Холангит, хирургическое лечение, малоинвазивные процедуры, билиарная декомпрессия, терапевтические результатыАннотация
Данное исследование рассматривает клинические результаты различных хирургических вмешательств, проведенных у 74 пациентов основной исследуемой группы, на основе комплексной диагностической оценки холангита и его патогенетических механизмов. Результаты показывают, что при среднетяжелом и тяжелом холангите оптимальным является двухэтапный хирургический подход. Первый этап должен включать либо эндоскопическую папиллосфинктеротомию (ЭПСТ) с назобилиарным дренированием (НБД), либо чрескожные вмешательства под ультразвуковым контролем. После достижения параметров легкой степени тяжести могут быть выполнены окончательные хирургические вмешательства.
Терапевтическая стратегия, подчеркивающая преимущественное использование малоинвазивных методов декомпрессии, калиброванных в соответствии с тяжестью острого гнойного холангита, продемонстрировала значительные клинические преимущества. Этот подход эффективно разрешил холестаз и септическую токсичность, что привело к снижению септических и холемических осложнений с 23,4% до 14,8%, с соответствующим снижением показателей смертности с 6,3% до 4,1%.
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