SURGICAL TACTICS FOR CHOLELITHIASIS WITH COMPLICATIONS OBSTRUCTIVE JAUNDICE

Аннотация

The purpose of the work: Comparative analysis of the use of different methods of biliary compression in patients with mechanical jaundice, a complication of gallstone disease. Materials and methods: We analysed 116 patients who were treated for cholelithiasis complicated by mechanical jaundice between years 2020 and 2023 in the Samarkand city medical association. As supporters, treatment for mechanical jaundice, we carried out decompression and sanitation biliary tract. This was done by using of retrograde endoscopic method. Results. Endoscopic papillosphincterotomy carried out in 68 patients (58,6%). Choledocholithoextraction performed in 39 patients (57,3%). The indication for drainage were: multiple choledocholithiasis, the lack of confidence in an adequate sanitation of hepaticocholedochus and cholangitis. Repeated control retrograde interventions was performed in quarter of them, technically in 29 patients. After restoration of passage of bile and the elimination of jaundice mini-access managed cholecystectomy was carried out in 54 patients. Mini-laparotomy of cholecystectomy and drainage of choledoch through the stump cystic duct was performed in 14 patients. In 48 patients, it was revealed that was impossible to perform endoscopic interventions due to difficulties of catheterization of BDC . Conclusions. We believe that, using two-staged minimally invasive treatment is optimal approach for obstructive jaundice. We consider if it is impossible to drainage bile ducts, external and internal drainage of the common bile duct is necessary to restore the continuous passages of bile into the intestines by laparotomy method.