Transpapillary Intervention with Choledocholithiasis and Its Complications

Abstract


The purpose of the study To improve and evaluate the results of interventions at transpapillary choledocholithiasis and complications. Material and methods We analyzed treatment results 202 patients with gallstone disease (GSD), choledocholithiasis and its complications. In the first group were 112 (55%) patients and in the first stage was carried out endoscopic treatment of choledocholithiasis, then executed videolaparoscopic cholecystectomy (LCE). In the second group, 90 (45%) patients was used one-step treatment - LCE performed with simultaneous APT. Results and their discussion The two-stage method of treatment of choledocholithiasis with using minimally invasive technologies in 9% was unsuccessful due to the inability transpapillary treatment choledocholithiasis and stenosis MDP; in 11,6% of cases endoscopic papillosphincterotomy (EPT) is fraught with the development postmanipulyatsionnogo pancreatitis; antegrade papillosphincterotomy (PLA) during videolaparoscopic cholecystectomy (VLHE) in 95,5% enables one stage of cholelithiasis and choledocholithiasis allow its complications, excluding the possibility of developing pancreatitis after manipulation. Conclusion 1. The results of surgical treatment of first and second groups showed that at one stage treatment of choledocholithiasis and its complications preference should be given videolaparoscopic interventions with simultaneous APT. 2. One-step treatment of choledocholithiasis have economic advantagesby allowing to reduce duration of hospital treatment up to 5±2.4 bed days in comparison with 14±2.3 for the two-stage treatment. Key words Choledocholithiasis, transpapillary intervention

Kursk State Medical University, 3 K.Marksa Str., Kursk, 305040, Russian Federation

Author for correspondence.
Email: mail@vestnik-surgery.com
Prof., Head of the department of surgical diseases №2 of Kursk State Medical University;

Kursk State Medical University, 3 K.Marksa Str., Kursk, 305040, Russian Federation

Email: mail@vestnik-surgery.com
Prof. of the department of surgical diseases №2 of Kursk State Medical University;

Kursk State Medical University, 3 K.Marksa Str., Kursk, 305040, Russian Federation

Email: mail@vestnik-surgery.com
Prof. of the department of surgical diseases №2 of Kursk State Medical University;

Kursk State Medical University, 3 K.Marksa Str., Kursk, 305040, Russian Federation

Email: tass@list.ru
Ass. Prof. of the department of surgical diseases №2 of Kursk State Medical University.

Kursk State Medical University, 3 K.Marksa Str., Kursk, 305040, Russian Federation

Email: mail@vestnik-surgery.com
graduate student of the department of surgical diseases №2 of Kursk State Medical University;

Kursk State Medical University, 3 K.Marksa Str., Kursk, 305040, Russian Federation

Email: mail@vestnik-surgery.com
Prof. of the department of biology and medical genetics of Kursk State Medical University.

  1. Kanishchev YU.V., Nazarenko N.P., Volkov D.V. Antegradnaya papillosfinkterotomiya v lechenii oslozhnennykh form zhelchnokamennoy bolezni. [Antegrade papillosphincterotomy in the treatment of complicated forms of cholelithiasis]. Annaly khirurgicheskoy gepatologii, 2008; 13: 3: 55.
  2. Kriger A.G., Mayorova Ye.G. Laparoskopicheskoye lecheniye bol'nykh kholedokholitiazom. [Laparoscopic treatment of patients with choledocholithiasis]. Annaly khirurgicheskoy gepatologii, 1998; 2: 88-91.
  3. Nazarenko P.M., Kanishchev YU.V., Nazarenko D.P. Intraoperatsionnoye razresheniye patologii zhelchnykh protokov vo vremya laparoskopicheskoy kholetsistektomii. Fiziologiya i patologiya zabolevaniy pishchevoda: materialy nauch.programmy uchreditel'nogo s"yezda Rossiyskogo obshchestva khirurgov-gastroenterologov.[Intraoperative resolution pathology of the bile duct during laparoscopic holetsistoektomii. Physiology and pathology of diseases of the esophagus: the material and scientific programs of the constituent congress of the Russian Society of Gastroenterology surgeons.] Sochi, 2004; 118-119.
  4. Okhotnikov O.I., Yakovleva M.V., Grigor'yev S.N. Anteradnyye endobiliarnyye vmeshatel'stva v lechenii oslozhnennoy zhelchnokamennoy bolezni.[Antegrade endobiliary intervention in the treatment of complicated cholelithiasis]. Annaly khirurgicheskoy gepatologii, 2013; 18: 1: 29-37.
  5. Adib R. Mogut li vse kamni obshhego zhelchnogo protoka prosmatrivat'sja vo vremja laparoskopicheskoj holecistjektomii? [Can all common bile duct stones be treated at the time of the laparoscopic cholecystectomy?]. Abstracts 11 th EAES Congress, 2003; 160.
  6. Cax M.R., Wilson C.W. Predoperacionnaja jendoskopicheskoe sfinkterotomija pri laparoskopicheskoj holecistjektomii dlja holedoholitiaza. [Per-operative endoscopic sphincterotomy during laparoscopic cholecystectomy for choledocholithiasis]. Br. J. Surg., 1995; 82: 257-259.
  7. Chandio A., Timmons S.Faktory, vlijajushhie na uspeshnoe zavershenie laparoskopicheskoj holecistjektomii. [Factors influencing the successful completion of laparoscopic cholecystectomy]. JSLS, 2009; 13: 581-586.
  8. Freeman M.L., Nelson D.V.Oslozhnenija endoskopicheskoj sfinkterotomii zhelchnyh protokov. [Complications of endoscopic biliary sphincterotomy]. N. Engl. J. Med., 1996; 335: 909-918.

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