Hybrid surgical interventions in treatment of cholangitis and biliary sepsis on the background of cholecystocholedocholithiasis
https://doi.org/10.24884/0042-4625-2019-178-3-34-38
Abstract
The OBJECTIVE of the study was to improve the results of treatment in patients with cholecystocholedocholithiasis complicated with acute cholangitis and biliary sepsis by analyzing the possibilities of hybrid surgery.
MATERIAL AND METHODS. 126 patients with acute cholecystitis, cholangitis and biliary sepsis on the background of the cholecystocholedocholithiasis were treated during the period 2015–2018. We performed the comparative analysis of treatment results in different groups for evaluating the effectiveness of various hybrid operations.
RESULTS. When analyzing the comparison of treatment results we determined that single-stage laparoscopic biliary tract lavage was more effective in the case of large or multiple bile ductus stones. Endoscopic transpapillary management performed by «Rendezvous» method was more effective than endoscopic papillosphincterotomy.
CONCLUSION. With the development of acute cholecystitis, cholangitis and biliary sepsis on the background of cholecystocholedocholithiasis, the implementation of single-stage hybrid surgical interventions taking into a specificity for each of the methods was indicated.
About the Authors
D. N. Popov
Pavlov University
Russian Federation
Russia, St. Petersburg
Russian Federation
Russia, St. Petersburg
A. O. Tantsev
Pavlov University
Russia, St. Petersburg
Russia, St. Petersburg
T. O. Nikitina
Pavlov University
Russia, St. Petersburg
Russia, St. Petersburg
A. U. Korolkov
Pavlov University
Russia, St. Petersburg
Russia, St. Petersburg
References
1. Malahova I. G., Shklyaev A. E., Utkin I. Yu. Ostryj holangit, oslozhnyonnyj biliarnym sepsisom: Klinicheskij sluchaj s blagopriyatnym iskhodom. Arhiv vnutrennej mediciny. 2016;(4):65–69. (In Russ.).
2. Hacko V. V., Potapov V. V., Zenin O. K. Biliarnyj sepsis zhelchnokamennoj etiologii. // Medicinskie nauki. Klinicheskaya medicina. 2016;(3):62–67. (In Russ.).
3. Tarasenko S. V., Zajcev O. V., Tyulenev D. O. Rasprostranyonnost’ oslozhnyonnyh form zhelchekamennoj bolezni. Nauka molodyh (Eruditio Juvenium). 2018;(2):218–224. (In Russ.).
4. Borisov A. E., Kashchenko V. A., Kubachev K. G. Puti optimizacii standartov lecheniya ostrogo holecistita. Vestnik khirurgii im. I. I. Grekova. 2012;(6):80–85. (In Russ.).
5. Wada K., Takada T., Kawarada Y. et al. Diagnostic criteria and severity assessment of acute cholangitis: Tokyo Guidelines. J. Hepatobiliary Pancreat. Surg. 2007;(14):52–58.
6. Gracanin A., Kujundzic M., Petrovecki M. et al. Etiology and epidemiology of obstructive jaundice. Coll. Antropol. 2013;37(1):131–133.
7. Modha K. Clinical approach to patients with obstructive jaundice. Tech Vasc Interv Radiol. 2015:18(4):197–200.
8. Danilov S. A., Kohanenko N. Yu., Ivanov A. L. Sovremennye tendencii v lechenii holecistoholedoholitiaza. Vestnik SPbGU. 2011;(3):52–60. (In Russ.).
9. Tan C., Ocampo O., Ong R. et al. Comparison of one stage laparoscopic cholecystectomy combined with intra-operative endoscopic sphincterotomy versus two-stage pre-operative endoscopic sphincterotomy followed by laparoscopic cholecystectomy for the management of pre-operatively diagnosed patients with common bile duct stones : a meta-analysis. Surg. Endosc. 2018;(32):770–778.
10. Mattilla A., Johanna M., Ilmeo K. Cost-analysis and effectiveness of one-stage laparoscopic versus two-stage endolaparoscopic management of cholecystocholedocholithiasis : a retrospective cohort study. BMC Surgery. 2017;17. Doi: 10.1186/s12893-017-0274-2.
11. Lu J., Cheng Y., Xiong X. et al. Two-stage vs single-stage management for concomitant gallstones and common bile duct stones. World J. Gastrointerol. 2012;18(24):3156–3166.
Review
For citations:
Popov D.N., Tantsev A.O., Nikitina T.O., Korolkov A.U. Hybrid surgical interventions in treatment of cholangitis and biliary sepsis on the background of cholecystocholedocholithiasis. Grekov's Bulletin of Surgery. 2019;178(3):34-38. (In Russ.) https://doi.org/10.24884/0042-4625-2019-178-3-34-38
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