The problem of diagnostics of small symptomatic choledocholithiasis in patients with acute calculus cholecystitis
DOI:
https://doi.org/10.11603/2414-4533.2018.2.9195Keywords:
small symptomatic choledocholithiasis, ultrasonography, endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography.Abstract
The aim of the work: to improve the results of the diagnosis of small symptomatic c holedocholithiasis.
Materials and Methods. Diagnosis and treatment of 167 patients with acute calculous cholecystitis and suspicion of choledocholithiasis in the period from 2007 to 2016 were analyzed.
Results and Discussion. In patients with acute calculous cholecystitis and small symptomatic choledocholithiasis, the pain in the right hypochondrium and epigastric areas (95.8 %), body temperature (47.9%), and general weakness (87.4 %) and only in 4 (2.3 %) of patients watched the Sharko triad (jaundice, fever, chills). In the analysis of biochemical parameters of blood, we observed an increase in the level of bilirubin in only 38 (22.7 %) patients, and alkaline phosphatase in 131 (78.4 %) and gama-glutamyl transpeptidase in 139 (83.2 %) patients. According to the results of ultrasound signs of choledocholithiasis isolated in 68.8 % of patients; the diameter of the total bile duct was on average (9.0±0.21) mm. There were not ultrasound signs of hypertension or other biliary pathology in 52 (31.1 %) patients. Among 41 patients with MRCP, choledocholithiasis was diagnosed in 30 (73.2 %) patients. Dur
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