1. [The surgical tactics of treatment of the choledocholithiasis, complicated by the obstructive jaundice, in patients with the altered bilioduodenal anatomy].
- Author
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Shapoval'iants SG, Ardasenov TB, Fedorov ED, Myl'nikov AG, Pan'kov AG, Budzinskiĭ SA, Ivanova EV, and Bachurin AN
- Subjects
- Aged, Aged, 80 and over, Bile Duct Diseases complications, Bile Duct Diseases physiopathology, Choledocholithiasis complications, Choledocholithiasis physiopathology, Constriction, Pathologic etiology, Decompression, Surgical methods, Duodenal Diseases complications, Duodenal Diseases physiopathology, Female, Humans, Jaundice, Obstructive etiology, Jaundice, Obstructive physiopathology, Male, Middle Aged, Palliative Care methods, Stents, Treatment Outcome, Choledocholithiasis surgery, Constriction, Pathologic surgery, Digestive System Surgical Procedures adverse effects, Digestive System Surgical Procedures methods, Jaundice, Obstructive surgery, Postoperative Complications prevention & control
- Abstract
The treatment results of 69 patients with the altered bilioduodenal anatomy and choledocholithiasis, complicated by the obstructive jaundice, were analyzed. The anatomic changes were determined by the previous gastric resection or gastrectomy, biliodigestive anastomosis, bile duct strictures, pyloric stenosis, duodenal diverticulum or the Mirizzi syndrome. The surgical approach depended on the type and extent of anatomic changes. The endoscopic common bile duct decompression was possible in 82,6% of patients. The endoscopic bile duct stone removal was achieved only in 44,9% of patients, the other 8,7% with non-removable stones had the endoscopic bile duct stenting as a means of palliative surgery. Percutaneous transhepatic lithoextraction was performed in 1,5% of cases. The differential approach provided the decrease of postoperative complication rate and lethality to 14,5 and 2,9%, respectively.
- Published
- 2011