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Khirurgii
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Научно-практическая конференция с международным участием и
XXVIII Пленум Правления Белорусской ассоциации хирургов
«Актуальные вопросы и современные подходы в оказании
хирургической помощи в Республике Беларусь»
18-19 ноября 2021 года в г. Минск.






Year 2006 Vol. 14 No 4

MODERN DIAGNOSTICS AND THERAPY

AL-FIDI A.A.N., DUNDAROV Z.A.

TREATMENT TACTICS IN THE PATIENTS WITH ACUTE CHOLANGIOGENIC INFECTION

The results of 97 patients with acute cholangiogenic infection treatment from the basic group and 96 patients from the control group are studied. Both groups are comparable. On the basis of the clinical-laboratory criteria and outcomes, the patients are subdivided into three subgroups: with favorable course of acute cholangiogenic infections (53,9%), with acute suppurative cholangiogenic infection (28,5%) and with septic course of acute cholangiogenic infection (17,6%). Early decompression of the biliary ducts was considered to be the basis of treatment. Operative interventions in the patients of the basic group were carried out from the mini- laparotomy access using specialized tool-set (firm”SAN”, Russia). In the control group, the operations, aimed to eliminate the obturation cause and the biliary ducts sanitation, were carried out from the traditional laparotomy access. In the cases of reliable and radical elimination of the biliary hypertension cause by EPST method, cholecystectomy was carried out by means of laparoscopy in the extended period. The operations from mini-laparotomy access in the patients with acute cholangiogenic infection allow performing the full range of manipulations on the biliary ducts and they correspond completely to the principles of insignificant invasiveness, adequacy and profitability. In the patients with favorable course of cholangiogenic infection it is more expedient to carry out one-stage radical surgical intervention from mini-laparotomy access, which will permit to cut down the total number of complications and terms of treatment considerably. Because of their insignificant traumatism, surgical interventions from mini-access are endured much easier by the patients and are accompanied by smaller number of post-operative complications and fatal outcomes.

Keywords: acute cholangiogenic infection, septic course, biliary hypertension, operative treatment, bile ducts decompression
p. 70 - 76 of the original issue
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