Open AccessCLINICAL EFFICIENCY OF OPEN AND ENDOSCOPIC INTERVENTIONS WITH OBSTACLES OF THE TERMINAL DEPARTMENT OF CHOLEDOCH IN PATIENTS WITH GALLSTONE DISEASE OF ELDERLY AND SENILE AGE
Author(s) -
D.Yu. Riazanov,
Yu.A. Mikheiev,
O.F. Shpylenko
Publication year - 2021
Publication title -
harkìvsʹka hìrurgìčna škola
Language(s) - English
Resource type - Journals
ISSN - 2308-7005
DOI - 10.37699/2308-7005.4.2021.08
Subject(s) - medicine , common bile duct , bile duct , incidence (geometry) , endoscopic stenting , surgery , general surgery , endoscopy , physics , optics
Summary. Purpose. To optimize the tactics of endoscopic interventions for cholelithiasis complicated by obstruction of the terminal portion of the common bile duct to reduce the incidence of postoperative complications and mortality in elderly and senile people.
Materials and methods. The results of examination and treatment of 221 elderly and senile patients with cholelithiasis complicated by obstruction of the terminal section of the common bile duct were analyzed.
Results. Using of existing methods and proposed new methods of endoscopic management of cholelithiasis complicated by obstruction of the terminal section of the common bile duct allow to reliably reduce the incidence of postoperative complications in elderly and senile patients from 19.8 to 9.5%, postoperative mortality from 10.3 to 2.9%
Conclusions. In elderly and senile patients with obstruction of the terminal section of the common bile duct and common bile duct stones who bear high operational risk, endoscopic papillosphincterotomy with stone removal is a sufficient method of treatment. In case of unremovable common bile duct stones, endoscopic papillosphincterotomy and stenting allow to avoid revision of the common bile duct, and in high-risk patients those methods allow to refrain from open surgery.