Miniinvasive interventions at malignant diseases of the hepatopancreatoduodenal zone, complicated with an obstructive jaundice

Abstract

Background: 225 patients with malignant diseases of the hepatopancreatoduodenal zone organs, complicated with an obstructive jaundice were cured in 2010-2015 in Orel regional clinical Hospital. Methods: The reasons of obstructive jaundice were: pancreatic head cancer - 60.9%, cholangiocarcinoma of common bile duct - 14.7%, cholangiocarcinoma of proximal bile ducts - 6.2%, gallbladder cancer - 5.8%, cancer of the major duodenal papilla - 2.6%, regional metastases - 9.8%. Results: 305 miniinvasive interventions were conducted: external cholangiostomy - 63%; antegrade endobiliary stenting - 22.3%; external-internal drainage of ducts - 11.8%; antegrade balloon plastic -0.6%; transcutaneous-transhepaticc micro holetsistostomiya - 2,3%. Complication were in 50 cases, and were mediated by dislocation of holangiostomic drainage in 24 patients (10.7%); by acute cholecystitis in 9 cases (4%); by acute pancreatitis in 5 cases (2.2%); by hydrothorax in 8 patients (3.6%). Lethal outcome appeared in 14 patients, and was due to the progression of the main disease. Conclusion: Thus, miniinvasive intervention at malignant diseases of the hepatopancreatoduodenal zone organs, complicated with obstructive jaundice, allow timely and effectively to determine the level of the biliary tract obstruction, to stop biliary hypertension, to improve the general condition of the patients and to determine further treatment strategy.