Relaparotomy and repeated minimally invasive interventions in hepatobiliary surgery

Abstract

Aim. To improve the immediate results of surgical treatment of injuries, and diseases of the liver and biliary tract through the rational use of minimally invasive technologies. Material and methods. Over the past 18 years, 6548 surgical interventions on the liver and biliary tract were performed. Postoperative intra-abdominal complications were observed in 643 (9.8 %) patients. At the same time, in 420 (6.4 %) cases, various options for repeated surgical interventions were used. Results. In 46 (23.4 %) cases, patients of the main group underwent laparoscopic cholecystectomy with endoscopic papillosphincterotomy (n = 10). In 5 (2.5 %) cases, percutaneous transhepatic cholangiography was performed to stop obstructive jaundice. Traditional surgical interventions with the formation of various variants of biliodegistic anastomoses were performed in 103 (52.5 %) patients. Postoperative complications in the main group were 23.0 %, and mortality was 9.6 %, while in the control group of patients, these figures were 36.0% and 19.3%, respectively. Conclusion. In the treatment of early postoperative intra-abdominal complications after surgical interventions on the liver and biliary tract, minimally invasive technology per indication is certainly considered the method of choice.