Transpapillary Intervention with Choledocholithiasis and Its Complications

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