Preview

Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)

Advanced search

ENDOSCOPIC TRANSPAPILLARY STENTING OF THE DUCTUS HEPATICOCHOLEDOCHUS IN PATIENTS WITH MECHANICAL JAUNDICE ASSOCIATED WITH TUMORS

Abstract

Endoscopic interventions have become increasingly popular in the treatment of patients with choledocholithiasis complicated by mechanical jaundice and cholangitis along with conventional surgeries.

Objective: to analyze the outcomes of endoscopic transpapillary interventions in the treatment of choledocholithiasis.

Interventions on the major duodenal papilla were performed in 286 patients with mechanical jaundice associated with choledocholiasis. The study population included 208 females and 78 males; mean age was 64 years; 72% of patients were older than 60 years.

In 255 patients (87.7%) with relatively small (between 0.8 and 1.4 cm) single and multiple common bile duct stones, we managed to extract the concrements into the intestine during endoscopic procedures. Before that, all patients had undergone endoscopic papillotomy to facilitate subsequent stone extraction. The length of papillotomy incision depended on the size of the longitudinal fold, but did not exceed 6–8 mm. In 55 out of 256 patients, a nasobiliary drainage was installed in order to reduce mechanical jaundice and eliminate cholangitis.

Nasobiliary drainage and common bile duct stenting improved patient condition and helped to prepare the patient for more radical endoscopic or surgical treatment. 

About the Authors

Yu. I. Biktagirov
State Budgetary Healthcare Institution ‘V.D. Seredavin Samara Regional Clinical Hospital,’ Samara
Russian Federation


M. L. Shteyner
Federal State Budgetary Institution of Higher Education ‘Samara State Medical University,’ Ministry of Health of the Russian Federation
Russian Federation
Samara


E. A. Korymasov
Federal State Budgetary Institution of Higher Education ‘Samara State Medical University,’ Ministry of Health of the Russian Federation
Russian Federation
Samara


E. P. Krivoshchekov
Federal State Budgetary Institution of Higher Education ‘Samara State Medical University,’ Ministry of Health of the Russian Federation
Russian Federation
Samara


B. M. Rakhimov
State Budgetary Healthcare Institution ‘Tolyatti City Clinical Hospital No. 5’
Russian Federation
Tolyatti


References

1. Blohin N.N., Itin A.B., Klimenkov A.A. Rak podzheludochnoj zhelezy i vnepechenochnyh zhelchnyh protokov. – M.: Medicina, 1982. – 259 s.

2. Danilov M.V., Garelik P.V., Glabaj V.P. i dr. Vybor zhelcheotvodyashchih operacij pri opuholevoj neprohodimosti distal'nyh otdelov zhelchnogo protoka // Hirurgiya. – 1993. – № 10. – S. 70–74.

3. Ermolov A..S., Yurchenko S.V., Dasaev N.A. Dekompressiya zhelchevyvodyashchih putej dlya podgotovki bol'nyh s obturacionnoj zheltuhoj i holangitom k radikal'noj operacii // Hirurgiya. – 1994. – № 9. – S. 24–27.

4. Maady A.S. Obosnovanie primeneniya endoskopicheskih sposobov drenirovaniya zhelchnyh putej pri zlokachestvennyh novoobrazovaniyah organov pankreatobiliarnoj zony, oslozhnennyh mekhanicheskoj zheltuhoj: avtoref. dis. … kand. med. nauk. – M., 2002. – 28 s.

5. Karimov Sh.I. Endobiliarnye vmeshatel'stva v diagnostike i lechenii bol'nyh s mekhanicheskoj zheltu-hoj. – Tashkent: Izdatel'stvo im. Ibn Siny, 1994. – 239 s.

6. Hrustaleva M.V. Sovremennye endoskopicheskie transpapillyarnye metody lecheniya mekhanicheskoj zheltuhi // Annaly NCH RAMN. – 1997. – S. 39–42.

7. Dolgushin B.I., Nechipaj A.M., Cherkasov V.A. i dr. Sochetannoe s endoskopiej intervencionnoradiologicheskoe vosstanovlenie vnutrennego zhelcheotvedeniya v onkologii // Lechenie obturacionno-go sindroma u onkologicheskih bol'nyh: mater. II nauch. -praktich. konf. intervencionnyh onkoradio-logov. – Kazan', 2009. – S. 12–13.

8. Burdyukov M.S. Diagnosticheskaya i lechebnaya endoskopiya pri opuholyah organov biliopankreatoduodenal'noj zony: avtoref. dis. … kand. med. nauk. – M., 2010. – 30 s.

9. Pancyrev Yu.M., Shapoval'yanc S.G., Orlov S.Yu., i dr. Vozmozhnosti endoskopicheskogo bilioduodenal'-nogo protezirovaniya v lechenii okklyuzionnyh porazhenij vnepechenochnyh zhelchnyh protokov // Shchadyashchie metody lecheniya v hirurgii: tez. konf. – M., 2003. – S. 76–83.

10. Huibregtse K., Katon R.M., Coene P.P., Tytgat G.N. Endoscopic palliative treatment in pancreatic cancer // Gastro-intest. Endosc. – 1986. – Vol. 32, № 5. – Р. 334–338.

11. Shepherd H.A., Royle G., Ross A.P. et al. Endoscopic biliary endoprosthesis in the palliation of malignant obstruc-tion of the distal common bile duct: a randomized trial // Br. J. Surg. – 1988. – Vol. 75. – Р. 1166–1168.


Review

For citations:


Biktagirov Yu.I., Shteyner M.L., Korymasov E.A., Krivoshchekov E.P., Rakhimov B.M. ENDOSCOPIC TRANSPAPILLARY STENTING OF THE DUCTUS HEPATICOCHOLEDOCHUS IN PATIENTS WITH MECHANICAL JAUNDICE ASSOCIATED WITH TUMORS. Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH). 2020;(2):57-61. (In Russ.)

Views: 272


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2226-762X (Print)
ISSN 2782-1579 (Online)