Endoscopic transpapillary interventions in the treatment of choledocholithiasis

DOI: https://doi.org/10.29296/25877305-2020-01-11
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1
Year: 
2020

Yu. Biktagirov(1), Candidate of Medical Sciences; M. Shteiner(1, 2), MD; Professor E. Korymasov(2), MD; Professor E. Krivoshchekov(2), MD; B. Rakhimov(3), MD (1)V.D. Seredavin Samara Regional Clinical Hospital (2)Samara State Medical University (3)Tolyatti City Clinical Hospital Five

Introduction. Recently, in the treatment of patients with choledocholithiasis complicated by obstructive jaundice and cholangitis, along with traditional surgical interventions, endoscopic interventions are increasingly used. Purpose. To study the results of endoscopic transpapillary interventions in the treatment of choledocholithiasis. Material and methods. Interventions on the large duodenal papilla were performed in 286 patients with obstructive jaundice caused by choledocholiasis. There were 208 women, 78 men, the average age of patients was 64 years old, over 60 years old was 72%. Results. In 255 (87.7%) patients with single and multiple stones of the common bile duct of relatively small diameter (from 0.8 to 1.4 cm), after performing various endoscopic procedures, it was possible to extract calculi into the intestinal lumen. All patients previously performed endoscopic papillotomy, which facilitated the subsequent extraction of stones. The length of the papillotomy incision depended on the severity of the longitudinal fold and did not exceed 6–8 mm. In 55 of the 256 patients, nasobiliary drainage was installed, which made it possible to reduce the effects of obstructive jaundice and stop the phenomena of cholangitis. Conclusion. Nasobiliary drainage and endoprosthetics of the choledochus can improve the condition of patients and prepare for more radical endoscopic and surgical treatment.
Keywords: 
choledocholithiasis
transpapillary
common bile duct
major duodenal papilla

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