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Одноэтапные лапароскопические операции при холецистохоледохолитиазе

Одноэтапные лапароскопические операции при холецистохоледохолитиазе

Abstract

Objectives. To evaluate the possibilities of laparoscopic technologies in treatment of patients with cholecystocholedocholithiasis. Methods. The treatment results of 94 patients with cholecystocholedocholithiasis are analyzed in the article laparoscopic surgeries were carried out in 94 patients and had successful outcomes in 92 patients (97,8%); the other 2 patients (2,1%) underwent the conversion (laparotomy, choledocholithotomy, Ker's choledoch drainage). Results. In 30 cases (32%) laparoscopic cholecystectomy (LCE) was done, extraction of concretions through the cystic duct, Halsted-Pikovsky choledoch drainage; in 59 cases (62,7%) LCE, choledocholithotomy, Ker's common bile drainage; in 3 cases (3,2%) LCE combined with supraduodenal choledochoduodenostomy; in 2 cases (2,1%) conversion to the laparoscopic access was performed because of the laparoscopic choledocholithotomy failure. Conclusions. Single-stage laparoscopic methods of cholecystocholedocholithiasis treatment are less traumatic and more physiologic ones and permit to save sphincter apparatus of the major duodenal papilla.

Цель. Оценить возможности применения лапароскопических технологий в лечении пациентов с холецистохоледохолитиазом. Материал и методы. В статье проанализированы результаты лечения 94 пациентов с холецистохоледохолитиазом. Лапароскопические операции были предприняты у 94 человек и успешно завершены у 92 (97,8%), остальным 2 (2,1%) пациентам была выполнена конверсия (лапаротомия, холедохолитотомия, дренирование холедоха по Керу). Результаты. В 30 (32%) случаях выполнена лапароскопическая холецистэктомия (ЛХЭ), экстракция конкрементов через пузырный проток, дренирование холедоха по Холстеду-Пиковскому; 59 (62,7%) ЛХЭ, холедохолитотомия, дренирование общего желчного протока по Керу; 3 (3,2%) ЛХЭ в сочетании с супрадуоденальной холедоходуоденостомией; 2 (2,1%) случаях при неудаче лапароскопической холедохолитотомии выполнена конверсия к лапаротомному доступу. Заключение. Одноэтапные лапароскопические методы лечения холецистохоледохолитиаза являются менее травматичными и более физиологичными, позволяют сохранить сфинктерный аппарат большого сосочка двенадцатиперстной кишки.

Keywords

ХОЛЕЦИСТОХОЛЕДОХОЛИТИАЗ, ОДНОЭТАПНЫЕ ЛАПАРОСКОПИЧЕСКИЕ ОПЕРАЦИИ, ЛАПАРОСКОПИЧЕСКАЯ ХОЛЕЦИСТЭКТОМИЯ, ЛАПАРОСКОПИЧЕСКАЯ ХОЛЕДОХОЛИТОТОМИЯ

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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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