Search

Obstructive jaundice is one of the main symptoms of diseases of hepatobiopancreatoduodenal region organs and occurs in 12.0-45.2% of cases. The article describes a clinical case of successful treatment of a patient with choledocholithiasis that occurred three years after gastropancreatoduodenal resection performed for pancreatic head cancer. Patients often die before they develop long-term postoperative complications, among which we can distinguish cicatricial strictures of biliodigestive anastomosis, which occur in 0.8% of cases, and the development of obstructive jaundice, which is primarily characteristic of the progression of the underlying disease or relapse. While analyzing the literature, we didnt find any statistically significant data regarding the incidence of gallstone disease (cholelithiasis) as a cause of obstructive jaundice in the patients after pancreatoduodenal resection. Thus, the clinical case presented below is of particular interest.

Aorto-mesenteric compression of the duodenum (Wilkie syndrome, upper mesenteric artery syndrome) is one of the causes of chronic duodenal obstruction. This condition is caused by compression of the horizontal branch of the duodenum between the abdominal aorta and the superior mesenteric artery, departing from the aorta at an acute angle. Among the causes of this pathological condition, an asthenic physique, pronounced weight loss in a short period of time, and others are distinguished. Currently, the main component of eliminating aorto-mesenteric compression is surgical intervention. Among other surgical methods, the most optimal is duodeno-jejunostomy according to AlbrechtStaveley. However, when this surgical intervention is associated with a high risk of developing a vicious circle syndrome. The developed modification of the AlbrechtStaveley operation aims to minimize the risks of developing the vicious circle syndrome.

Background. Liver cysts despite their low prevalence are an important issue in surgical hepatology. Among the indicatiors of the problem are often on the one hand, an asymptomatic course and on the other hand, possible complications such as compression of vessels and bile ducts, suppuration with abscesses and their rupture leading to peritonitis. Material and methods. The article presents the experience of treating the patient with a large nonparasitic liver cyst, as well as the technical aspects of surgery and the immediate results of the treatment. Results. The use of endovideosurgical technologies in treating patients with large nonparasitic liver cysts reduces the length of hospital stays, minimizing postoperative complications, as well as the period of rehabilitation. Conclusion. The use of external drainage of nonparasitic liver cysts under the control of medical imaging methods is preferable in the presence of infectious complications of cysts as a preparatory stage for radical treatment. Laparoscopic treatment of patients with large nonparasitic liver cysts is characterized by the lowest complication and recurrence rates and for repeated surgical interventions.