Abstract
Aim. To determine the effectiveness of endoscopic transpapillary techniques in diagnosis and treatment of patients with obstructive jaundice of various origin. Materials and Methods. We analyzed the effectiveness of endoscopic diagnosis and treatment of patients with obstructive jaundice for the period 2008–2012. The total number of patients was 900. Patients with mechanical obstacle for bile outflow and bilirubin level over 20 mmol/l were included. We used retrograde cholangiopancreatography (ERCP), endoscopic papillotomy (EPT), endoscopic mechanical lithotripsy and lithoextraction (EMLE, EMLT), nasobiliary drainage (NBD), probing and stenting of bile ducts, endoscopic contact electrohydraulic lithotripsy, balloon dilatation of the common bile duct. Results. Interventions were effective in 874 patients (97.11%). Complications occurred in 31 patients (3.44%). Mortality was absent. Conclusion. Endoscopic transpapillary interventions are highly effective in patients with obstructive jaundice. Instrumental hardware equipment and complex application have a great importance in this case.
Highlights
We analyzed the effectiveness of endoscopic diagnosis and treatment of patients with obstructive jaundice for the period 2008–2012
Endoscopic transpapillary interventions are highly effective in patients with obstructive jaundice
Дурлештер Владимир Моисеевич – доктор мед. наук, профессор, заместитель главного врача по хирургии ГБУЗ “Краевая клиническая больница No2”
Summary
Gabriel S.A., Durleshter V.M., Guchetl A.Ya., Andreev A.V., Dyn'ko V.Yu., Gol'fand V.V. Aim. To determine the effectiveness of endoscopic transpapillary techniques in diagnosis and treatment of patients with obstructive jaundice of various origin. We analyzed the effectiveness of endoscopic diagnosis and treatment of patients with obstructive jaundice for the period 2008–2012. Endoscopic transpapillary interventions are highly effective in patients with obstructive jaundice. Тяжелое состояние пациентов, сопутствующие заболевания и осложнения основного заболевания – основные факторы, поддерживающие стабильно высокую частоту осложнений и летальности при лечении этой категории больных. Поэтому первым этапом в лечении этой категории больных является восстановление оттока желчи и нормализация показателей биохимии крови. Применение эндоскопических транспапиллярных методов позволяет провести диагностику и восстановление пассажа желчи в 76–92% наблюдений, а частота ранних осложнений не превышает 3–5% [7–9]. Цель работы – определить эффективность эндоскопических транспапиллярных методов в диагностике и лечении пациентов с МЖ различной этиологии
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