The Use of Minimally Invasive Methods of Treatment of Obstructive Jaundice with Calculous Etiology

2015 ◽  
Vol 22 (3) ◽  
pp. 127-133
Author(s):  
Курманбаев ◽  
A. Kurmanbaev
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Minimally Invasive ◽  
Surgical Methods ◽  
The Common ◽  
Methods Of Treatment ◽  
Combined Interventions ◽  
Minimally Invasive Methods ◽  
Surgical Operations

The effectiveness of isolated retrograde endoscopic interventions and combined manipulations by the method «Randevu», also surgical operations for the purpose of elimination of choledocholithiasis, complicated by mechanical jaundice was defined on a large clinical material. It was identified a significant decline in hyperbilirubinemia in all used methods of treatment. Liver enzymes alanineaminotransferase and aspartate aminotransferase significantly reduced in the application of minimally invasive retrograde endoscopic and combined manipulations by the method «Randevu». There was a significant decrease in the diameter of the common bile duct by ultrasound only at the use of combined interventions by the method «Randevu». There was the greatest number of complications at the use of surgical methods of treatment of choledocholithiasis, complicated by mechanical jaundice, reaching 20% of cases. The rate of complications at the use of minimally invasive retrograde resolution methods of choledocholithiasis averaged 3% of cases. Postoperative complications are not observed at the use of the combined manipulations by the method "Randevu". Based on the analysis of the above data, the author determines the best treatment outcomes in patients with concomitant minimally invasive operations on the method of «Randevu», manifested a significant decrease in indicators of bilirubi-nemia, hepatic enzymes, diameter of the common bile duct. Also, this two-step tactic can be recommended for the extreme severity of the patient´s state, complicated by obstructive jaundice.

Causes, diagnosis, and treatment of postoperative obstructive jaundice

2021 ◽  
Vol 29 (2) ◽  
pp. 257-266
Author(s):  
Makhmadsho K. Gulov ◽  
Kakhramon R. Ruziboyzoda
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Minimally Invasive ◽  
Biliary Tract ◽  
Hepatic Duct ◽  
Abdominal Cavity ◽  
Surgical Interventions ◽  
Laparoscopic Operation ◽  
The Common

AIM: This study aimed to analyze the causes, diagnosis, and clinical treatment of postoperative obstructive jaundice (POOJ) in routine surgical practice. MATERIALS AND METHODS: Twenty-four patients with POOJ that developed in the organs of the hepatobiliary system after surgical interventions were included in this study. The patients were subjected to the following procedures to diagnose the causes of POOJ and choose the treatment methods: general clinical examination, biochemical blood tests, dynamic postoperative ultrasound examination of the abdominal organs, video laparoscopy, computed tomography, magnetic resonance imaging, fistulocholangiography, endoscopic retrograde cholagiopancreatography, and percutaneous transhepatic cholangiostomy. RESULTS: POOJ occurred in 18 cases after they had different variants of surgical interventions on the biliary tract after traditional (n = 6) and video laparoscopic cholecystectomy (n = 12). POOJ also developed in 6 cases after they underwent surgery on the liver: atypical (n = 2) and anatomical (n = 2) resection of the liver. This condition manifested after the opening and draining of liver abscesses under US control (n = 2). POOJ was treated with different methods to alleviate the developed complications. After surgical interventions on the liver and biliary tract in 6 cases, relaparotomy, sequestrectomy with sanation, drainage of the abdominal cavity (n = 4), and right-sided hemihepatectomy (n = 2) were performed. In 6 other cases, on days 34 of the development of POOJ after laparoscopic operation (n = 2), relaparotomy was performed, clips and ligature were removed from the choledoch with the formation of Roux-en-Y hepaticojejunostomy. Minimally invasive methods of POOJ correction were applied to 12 cases. Of the 12 cases, 5, 2, and 1 were subjected to endoscopic papillosphincterotomy with lithoextraction, endoscopic papillosphincterotomy with lithoextraction coupled with nasobiliary drainage, and relaparoscopy and redrainage of the common bile duct, respectively. In 4 cases, percutaneous transhepatic cholangiostomy was performed at the first stage. At the second stage, after POOJ resolution, the following procedures were implemented: redrainage of the common bile duct (n = 2) and dilatation of the orifice of the right hepatic duct with reconstruction of hepaticojejunostomy on the hidden transhepatic drainage. CONCLUSION: POOJ is still encountered in clinical practice in a sufficient number of cases. Treatment results largely depend on the time of diagnosis and the choice of optimal surgical strategies. The main causes of POOJ are tactical and technical diagnostic and treatment errors. POOJ is diagnosed on the basis of the data of modern radiation and laboratory and instrumental examination methods. Surgical tactics for POOJ are individually active and dependent on the severity, time, and causes of development. They also depend on the general condition of patients. Along with minimally invasive interventions for POOJ, early relaparotomy is less dangerous than passive expectation tactics.

scholarly journals Stage interventions in the treatment of patients with malignant diseases of the common bile duct terminal segment complicated by acute mechanical jaundice

2021 ◽  
pp. 34-40
Author(s):  
Stanislav Kosulin ◽  
Juriy Vinnik ◽  
Julia Ivanova
Keyword(s):  
Surgical Treatment ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Minimally Invasive ◽  
Terminal Segment ◽  
Surgical Trauma ◽  
Malignant Diseases ◽  
Minimal Invasiveness ◽  
The Common ◽  
Minimally Invasive Methods

Obstructive mechanical jaundice is a well-researched complication of various diseases and causes, yet considering patients` condition with malignant diseases according to the stage of the malignant process, severity of complications and etc. Selection of the most appropriate method of surgical treatment is always an option where it is essential to consider finding a way between efficiency and surgical trauma. The aim of the research is to optimize the results of surgical treatment of patients with malignant tumours of the common bile duct terminal segment complicated by acute mechanical jaundice. Materials and methods: patients over 18 y.o. with duodenal obstruction; the presence of other active cancer pathology or blood diseases. The research was performed on 2 different groups divided according to the use of biliary passability restoring method concluding the preferability of minimally invasive methods of bile duct decompression. Results: minimally invasive methods are not inferior to the effectiveness of biliary decompression comparing to open methods, have a number of advantages, such as minimal invasiveness, relative safety, low incidence of complications and mortality Conclusions: the introduction of the developed algorithm for surgical treatment of blastomatous mechanical jaundice with the consistent use of antegrade and open methods, as well as antegrade, retrograde and “rendezvous” techniques in surgically incurable patients allowed to reduce the number of early postoperative complications from 32.7 % to 13.3 %, the number of complications requiring surgery – from 5.8 % to 1.3 % and the level of postoperative mortality – from 11.5 % to 2.7 %.

Obstructive jaundice caused by circumscript papillomatosis of the common bile duct

2000 ◽  
Vol 32 (2) ◽  
pp. 88-89
Author(s):  
P. Ondrejka ◽  
A. Zabo ◽  
E. Siket ◽  
I. Sugar ◽  
B. Forgacs ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
The Common

Mechanical jaundice caused by common bile duct obstruction due to hepato-biliary ascariasis

2021 ◽  
pp. 20-24
Author(s):  
Zaipula Zulbegovich Nazhmudinov ◽  
Abdulkamal Guseynovich Guseynov
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Surgical Intervention ◽  
Duct Obstruction ◽  
Biliary Ascariasis ◽  
Modern Methods ◽  
Common Bile Duct Obstruction ◽  
The Common ◽  
The Right

The paper presents a case of successful surgical treatment of a patient with common bile duct ascariasis, which caused obstructive jaundice. Modern methods of examining a patient with obstructive jaundice did not allow to make the right diagnosis of the common bile duct ascariasis before surgical intervention. The rarity of this pathology arouses interest in this material.

scholarly journals Rhabdomyosarcoma of the biliary tract: a case report

2017 ◽  
Vol 4 (3) ◽  
pp. 1093 ◽  
Author(s):  
Asmaa Kouadir ◽  
Abderrahmane El Mazghi ◽  
Khalid Hassouni
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Biliary Tract ◽  
Clinical Symptoms ◽  
Treatment Approach ◽  
Imaging Techniques ◽  
Multidisciplinary Treatment ◽  
Rare Tumor ◽  
The Common

Rhabdomyosarcoma (RMS) of the biliary tract is a rare tumor that commonly arises from the common bile duct. The most common clinical symptoms are obstructive jaundice and abdominal pain. Although diagnosis is often difficult and is frequently made during surgery, diagnostic imaging techniques including ultrasound, computerized tomography scan, and magnetic resonance cholangiopancreatography remain useful in the diagnosis and evaluation of biliary tree anatomy. In order to improve prognosis, different rhabdomyosarcoma study groups have adopted multidisciplinary treatment approach. Herein we describe a case of three-year-old child with Embryonal rhabdomyosarcoma originating in the common bile duct who was treated with surgery, chemotherapy according to European soft tissue sarcoma group (EpSSG) protocol and adjuvant postoperative intensity modulated radiotherapy to surgical bed with 6 MV photons to a dose of 41, 4Gy in 23 fractions. One year and a half after the end of therapy, the patient is still disease free. Although Rhabdomyosarcoma of the biliary tract is a rare tumor, it should be considered in the differential diagnosis of patients who have obstructive jaundice and a cystic mass within the common bile duct. Once believed to be an incurable disease, the prognosis of patients with biliary rhabdomyosarcoma has improved with a multidisciplinary treatment approach.

Obstructive Jaundice Caused by Postsurgical Granuloma of the Common Bile Duct

Endoscopy ◽  
1980 ◽  
Vol 12 (05) ◽  
pp. 250-253 ◽  
Author(s):  
I. Farkas ◽  
A. Patkó ◽  
M. Kövári
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
The Common

Obstructive jaundice in children may be due to a malignant tumour of the common bile duct

1995 ◽  
Vol 10 (7) ◽  
Author(s):  
A.K. Sharma ◽  
B.K. Lahoti ◽  
R. Aggarwal ◽  
L.D. Agrawal ◽  
S.S. Sharma ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Malignant Tumour ◽  
The Common

scholarly journals Features of endobiliary stenting in unresectable tumors in the hepatopancreatoduodenal zone

2021 ◽  
Vol 26 (3) ◽  
pp. 70-78
Author(s):  
D. N. Panchenkov ◽  
Yu. V. Ivanov ◽  
D. V. Sazonov ◽  
A. I. Zlobin ◽  
A. V. Smirnov ◽  
...  
Keyword(s):  
Bile Duct ◽  
Life Expectancy ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Biliary Tract ◽  
Plastic Stents ◽  
Results Of Treatment ◽  
Nitinol Stents ◽  
The Common

Aim. Optimization of endobiliary stenting in patients with unresectable tumors of the organs in the hepatopancreatoduodenal zone, improving the prevention of complications, improving the immediate results of treatment and the quality of patient’s life.Material and methods. From 2011 to 2020, 47 patients with unresectable tumors in the hepatopancreatoduodenal zone underwent endoscopic transpapillary stenting of the common bile duct for obstructive jaundice. A plastic stent was used in 28 patients, and a self-expanding nitinol stent in 19 patients. The results of endobiliary stenting, complications, efficacy and safety of stenting, side effects, quality of biliary tract decompression were evaluated.Results. All patients were perform stenting of the common bile duct. Two complications were recorded during endoscopic transpapillary stenting: bleeding from the area of the major duodenal papilla, which was stopped endoscopically. In the immediate postoperative period – stent displacement was noted in 3 patients, blockage of the stent – in 2 cases, acute post-manipulative pancreatitis – in 1 case, cholangitis — in 2 patients. Satisfactory decompression of the biliary tract was achieved in 44 from 47 patients. There was 1 death.Conclusion. Endoscopic transpapillary stenting of the common bile duct is a low-traumatic, safe and effective method of biliary decompression for tumor obstructive jaundice. Plastic stents should be used for biliary drainage with a life expectancy of ≤6 months. Self-expanding nitinol stents with full or partial coverage is the best chose for life expectancy > 6 months.

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