Endoscopic papyllosphyncterotomy in patients with liver cirrhosis with cholestasis

Authors

  • A. F. Dzygal Odesa National Medical University

DOI:

https://doi.org/10.11603/2414-4533.2017.2.7942

Keywords:

liver cirrhosis, cholestasis, choledocholithyasis, endoscopic papyllosphyncterotomy, operation of choice.

Abstract

The aim of the work: to analyze the tactics of surgical treatment of patients with liver cirrhosis (LC) symptoms complicated by choledocholithiasis, for individual tactics of their treatment selection.

Materials and Methods. 52 patients with clinical manifestations of the biliary block due to a choledocholithyasis were selected out of 1117 examined patients with suspicion on LC, cholelithyasis, acute cholecystitis and mechanical jaundice. Endoscopic papyllosphyncterotomy (EPST) with lithextraction, EPST with mechanical lithotripsy, stenting and balloon dilatation as well as nazobiliary drainage were performed to 42 patients.

Results and Discussion. Authors formulated indications and contraindications to endoscopic operation at patients with the LC complicated with choledocholithyasis. Various types of EPST separate details – typical or cannulated, atypical or non-cannulated and mixed – are given. EPST was followed by lithextraction at 33 patients. EPST was successful at 35 of 37 patients. The complications after EPST found during operation or which developed within 24 hrs after it were registered at 6 out of 37 patients.

Conclusions. EPST efficiency at patients with LC with choledocholithyasis  and biliary tracts mechanical obstruction reaches 94.6% that allows author to recommend it as operation of choice at treatment of patients with the impassability of the general biliary tract which arose owing to a choledocholithyasis. It’s possible to consider this surgical intervention as an effective method of treatment of the specified contingent of patients with high degree of operational risk.

Author Biography

A. F. Dzygal, Odesa National Medical University

PhD, Associate Professor of the Department of Surgery N3 with the course of neurosurgery, Odessa National Medical University, Ukraine

References

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Alekseeva, O.P. & Kurysheva, M.A. (2004). Tsirroz pecheni i ego oslozhneniya [Liver cirrhosis and its complications]. N. Novgorod: Izd-vo Nizhegorod. gos. akad. [in Russian].

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Vetshev, P.S., Shulutko, A.M. & Prudkov, M.I. (2005) Khirurgicheskoe lechenie kholelitiaza: nezyblemye printsipy, schadyaschie tekhnologii [Surgical treatment of cholecystitis: unshakable principles, sparing technologies]. Khirurgiya – Surgery, 8, 91-93 [in Russian].

Yermolov, A.S., Upyrev, A.V., & Ivanov, P.A. (2004). Khirurgiya zhelchekamennoy bolezni [Surgery of cholelithiasis]. Khirurgiya – Surgery, 5, 4-9 [in Russian].

Nichitaylo, M.Ye. & Skums, A.V. (2006). Povrezhdeniya zhelchnykh protokov pri kholetsistektomii i ikh posledstviya [Damage of the bile ducts with cholecystectomy and their consequences]. Kiev: Makkom [in Russian].

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Published

2017-07-14

How to Cite

Dzygal, A. F. (2017). Endoscopic papyllosphyncterotomy in patients with liver cirrhosis with cholestasis. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (2), 61–65. https://doi.org/10.11603/2414-4533.2017.2.7942

Issue

No. 2 (2017)

Section

EXPERIENCE OF WORK

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