[Minimally invasive methods for treatment of cholelithiasis, complicated by choledocholithiasis]. / Maloinvazivnye metody lecheniia zhelchnokamennoi bolezni, oslozhnennoi zabolevaniem obshchego zhelchnogo protoka.

Disease of the common bile duct (choledochal duct) was revealed in 18 from 531 patients with bile tract lithiasis (3.4%), who underwent laparoscopic cholecystectomy and in 3 of 72 patients (5.4%), who underwent cholecystectomy through minilaparotomy approach. Stenosis of the large duodenal papilla was observed in 14 patients, choledocholithiasis in 9 patients. Endoscopic papillosphincterotomy (EPST) was performed in all cases. There were no complications. In 2 cases moderate amylasemia was detected. Laparoscopic cholecystectomy was performed 5 days after the procedure on the large duodenal papilla (5.1 days mean). Intervention with the use of mini-approach after EPST was carried out in patient with concrement of gall bladder duct stump, which was revealed 3 months after laparoscopic cholecystectomy. Mini-approach made it possible to perform reconstructive operations on bile ducts in combination with cholecystectomy in 3 patients. At present there are many tools which enable combined treatment of the bile tract lithiasis complicated by bile ducts pathology with low-invasive technique.