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Проблемы хирургического лечения ятрогенных повреждений и стриктур внепеченочных желчных протоков

Проблемы хирургического лечения ятрогенных повреждений и стриктур внепеченочных желчных протоков

Abstract

Частота повреждений желчных протоков при открытой холецистэктомии, по мнению многих авторов, занимающихся этой проблемой, остается стабильной и составляет высокий процент случаев и не имеет тенденции к снижению. Своевременность диагностики травмы при ятрогенных повреждениях магистральных желчных протоков, играет большое значение в благоприятном исходе этого сложного по своей структуре осложнения. Для первичной диагностики ятрогенной травмы желчевыводящих путей, в первую очередь, отдают предпочтение неинвазивным лучевым методам исследования (ультразвуковое исследование, компьютерная и магнитно-резонансная томография и др.). Подходы в хирургическом лечении ятрогенной травмы желчных протоков остаются предметом многочисленных дискуссий. Результат лечения зависит от ранней диагностики и выбранной хирургической тактики. Развитие малоинвазивных эндоскопических методов, чрескожных эндобилиарных методов интервенционной радиологии, а также накопление более векового опыта «открытой» гепатобилиарной хирургии служат основанием для изменения тактики хирургического лечения данной проблемы.

The frequency of bile duct injury during open cholecystectomy, according to many authors dealing with this issue, it remains stable at a high percentage of cases and has no tendency to decrease. Timely diagnosis of injury, when the main iatrogenic lesions of the bile ducts, plays great importance in the successful outcome of this complex in its structure complications. For primary diagnosis of iatrogenic biliary tract injury in the first place, prefer non-invasive radiological methods (ultrasound, computer tomography and magnetic resonance imaging, etc.). Approaches in the surgical treatment of iatrogenic bile duct injury remains the subject of much debate. Result of treatment depends on early diagnosis and surgical tactics chosen. Development of minimally invasive endoscopic techniques, percutaneous interventional radiology endobiliary methods, as well as the accumulation of more than a century of experience «open» hepatobiliary surgery serve as a basis for changing surgical treatment of this problem.

Keywords

ЖЕЛЧНЫЕ ПРОТОКИ, РУБЦОВЫЕ СТРИКТУРЫ, ЯТРОГЕННЫЕ ПОВРЕЖДЕНИЯ

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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