Minimally invasive surgery for obstructive jaundice caused by malignant tumors

Abstract

Purpose of the study . On the basis of the accumulated experience to optimize approaches to the preoperative preparation, technical aspects of X-ray surgical antegrade minimally invasive endobiliary interventions, rational postoperative management of patients in order to reduce postoperative complications, improving treatment outcomes and quality of life of patients. Materials and methods . We analyzed 1610 percutaneous transhepatic endobiliary surgeries with separate examination of 1186 X-ray surgical procedures of percutaneous external biliary drainage (PEBD) and 424 cases of antegrade endobiliary stenting (AEBS) Results. Complications after PEBD were developed in 9 (0.76%) patients: the procedure-related bleeding was noted in 3 (0.25%) cases, and bleeding caused by the progression of hepatic failure, hypocoagulation in 6 (0.5%) cases. 3 patients (0.25%) of this group died. Complications after AEBS were registered in 35 (8.3%) patients: acute postoperative pancreatitis in 24 (5.7%) cases, progression of liver failure, hypocoagulation in 9 (2.1%), tumor-induced duodenal stenosis in 2 (0.47%) cases. One patient (0.24%) of this group died. Reduction in complications after PEBD and AEBS is directly associated with surgery techniques, the use of special tools, and tactics of patient management. Conclusion. The prevention of complications, treatment outcomes, and the quality of life of patients receiving interventional antegrade endobiliary surgery are inextricably associated with the technical aspects of interventions, the tools and tool materials, necessary correction of endogenous toxicosis, pancreatitis, hepatic failure, and hemostatic system disorders. Constant monitoring of the results of new technologies is necessary to analyze gathered experience for possible correction and optimization of tactical approaches and schemes for more effective treatment of patients with this severe pathology.