THERAPEUTIC APPLICATIONS OF MINIMALLY INVASIVE DECOMPRESSION PROCEDURES IN THE SURGICAL MANAGEMENT OF CHOLANGITIS

Аннотация

This research examines the clinical outcomes of diverse surgical interventions performed on 74 patients in the primary study cohort, based on comprehensive diagnostic evaluation of cholangitis and its underlying pathogenetic mechanisms. The findings indicate that for moderate to severe cholangitis cases, a two-phase surgical approach is optimal. The initial phase should incorporate either Endoscopic Papillosphincterotomy (EPST) with Nasobiliary Drainage (NBD) or ultrasound-guided percutaneous interventions. Subsequently, following the achievement of mild severity parameters, definitive surgical procedures may be implemented. The therapeutic strategy emphasizing preferential utilization of minimally invasive decompression techniques, calibrated according to acute purulent cholangitis severity, demonstrated significant clinical benefits. This approach effectively resolved cholestasis and septic toxicity, resulting in a reduction of septic and cholemic complications from 23.4% to 14.8%, with a corresponding decrease in mortality rates from 6.3% to 4.1%.