Abstract
Obstructive mechanical jaundice is a well-researched complication of various diseases and causes, yet considering patients` condition with malignant diseases according to the stage of the malignant process, severity of complications and etc. Selection of the most appropriate method of surgical treatment is always an option where it is essential to consider finding a way between efficiency and surgical trauma.
 The aim of the research is to optimize the results of surgical treatment of patients with malignant tumours of the common bile duct terminal segment complicated by acute mechanical jaundice.
 Materials and methods: patients over 18 y.o. with duodenal obstruction; the presence of other active cancer pathology or blood diseases.
 The research was performed on 2 different groups divided according to the use of biliary passability restoring method concluding the preferability of minimally invasive methods of bile duct decompression.
 Results: minimally invasive methods are not inferior to the effectiveness of biliary decompression comparing to open methods, have a number of advantages, such as minimal invasiveness, relative safety, low incidence of complications and mortality
 Conclusions: the introduction of the developed algorithm for surgical treatment of blastomatous mechanical jaundice with the consistent use of antegrade and open methods, as well as antegrade, retrograde and “rendezvous” techniques in surgically incurable patients allowed to reduce the number of early postoperative complications from 32.7 % to 13.3 %, the number of complications requiring surgery – from 5.8 % to 1.3 % and the level of postoperative mortality – from 11.5 % to 2.7 %.
Highlights
Tumour diseases of the biliopancreatoduodenal zone (BPDZ) occupy one of the leading places among the causes of disability and mortality of the population, according to global and domestic statistics 85–90 % of such cases refer to patients with a tumour causing distal biliary obstruction [1]
The aim of the research was to optimizing the results of surgical treatment of patients with malignant tumours of the common bile duct terminal segment complicated by acute mechani cal jaundice
The first group was divided into three subgroups: the first (1.1) – 40 patients with OJ as the complications of pancreatic head cancer, the second (1.2) – 23 patients with OJ, caused by the obstruction of common bile duct (CBD) terminal part of tumour origin, third (1.3) – 12 patients with the major duodenal papilla (MDP) cancer as cause of OJ
Summary
Tumour diseases of the biliopancreatoduodenal zone (BPDZ) occupy one of the leading places among the causes of disability and mortality of the population, according to global and domestic statistics 85–90 % of such cases refer to patients with a tumour causing distal biliary obstruction [1]. They compose nearly 15 % of all malignant tumours of the gastrointestinal tract, which is 5–6 % among all malignant tumours diagnosed in Ukraine. If distant metastases or extensive local invasion are present, the method of surgical treatment as well as the frequency of complications and life expectancy do not differ significantly [6,7,8]
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