RESUMEN
The results of endoscopic transpapillary surgical interventions in 115 patients, suffering choledocholithiasis, caused by the multiple calculi presence, were analyzed. The patients were divided on four groups, depending on the treatment provided. In 78 patients (first group) endoscopic papillosphincterotomy with mechanical lithoextraction in conjunction with spasmolytic and infusion therapy were performed. In 16 patients (second group) endoscopic papillosphincterotomy with mechanical lithotripsy and partial lithoextraction, endobiliary stenting with further spasmolytic and infusion therapy were performed. In 11 patients (the third group) endoscopic papillosphincterotomy, mechanical lithotripsy with a partial lithoextraction and nasobiliary drainage were used. In 10 patients (the fourth group) endoscopic papillosphincterotomy, mechanical lithotripsy, nasobiliary drainage and endobiliary stenting were applied. The best results were achieved in the first group: the smallest duration of the operation--(32.2 +/- 12.6) min, the smallest stationary state duration--(3.3 +/- 1.2) days, the lowest rate of intraoperative complications--2.6%.
Asunto(s)
Coledocolitiasis/cirugía , Conducto Colédoco/cirugía , Duodenoscopía/métodos , Cálculos Biliares/cirugía , Adulto , Anciano , Coledocolitiasis/patología , Coledocolitiasis/terapia , Conducto Colédoco/patología , Drenaje , Duodenoscopía/efectos adversos , Femenino , Fluidoterapia , Cálculos Biliares/patología , Cálculos Biliares/terapia , Humanos , Complicaciones Intraoperatorias/patología , Complicaciones Intraoperatorias/prevención & control , Intubación Gastrointestinal , Litotricia/métodos , Masculino , Persona de Mediana Edad , Parasimpatolíticos/administración & dosificación , Parasimpatolíticos/uso terapéutico , Esfinterotomía Endoscópica/efectos adversos , Esfinterotomía Endoscópica/métodos , StentsRESUMEN
The results of endoscopic papillectomy, performed in 17 patients for tumors of duodenal large papilla in 2005-2010 yrs, were studied up. In 7 (41.2%) patients complications have occurred, including hemorrhage--in 4 (23.5%). All the patients are alive.
Asunto(s)
Ampolla Hepatopancreática/cirugía , Colangiopancreatografia Retrógrada Endoscópica/métodos , Neoplasias del Conducto Colédoco/cirugía , Electrocoagulación/métodos , Esfinterotomía Endoscópica/métodos , Ampolla Hepatopancreática/patología , Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Neoplasias del Conducto Colédoco/patología , Electrocoagulación/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esfinterotomía Endoscópica/efectos adversos , Resultado del TratamientoRESUMEN
The results of surgical treatment of patients, suffering choledocholithiasis, were adduced. In 493 patients laparoscopic exploration of common biliary duct was accomplished, in 297 of them the choledocholithiasis diagnosis was definitely established while performing laparoscopic cholecystectomy (LCHE); in 136--endoscopic papillosphincterotomy (EPST) was done preoperatively, but the attempts to perform transpapillary lithoextraction and lithotripsy have failed; in 60--a residual choledocholithiasis was noted. In 930 patients EPST and lithoextraction were performed preoperatively and as a second stage--LCHE.
Asunto(s)
Colecistectomía Laparoscópica/métodos , Coledocolitiasis/cirugía , Esfinterotomía Endoscópica/métodos , Adulto , Anciano , Colangiopancreatografia Retrógrada Endoscópica , Colecistectomía Laparoscópica/efectos adversos , Coledocolitiasis/complicaciones , Coledocolitiasis/diagnóstico por imagen , Femenino , Cálculos Biliares/complicaciones , Cálculos Biliares/diagnóstico por imagen , Cálculos Biliares/cirugía , Humanos , Masculino , Persona de Mediana Edad , Esfinterotomía Endoscópica/efectos adversos , Resultado del Tratamiento , UltrasonografíaRESUMEN
The results of atypical endoscopic papillotomy with subsequent transpapillary intervention, performed in the clinic in 2001-2006 for the diagnosis-treatment aim in 1090 patients, suffering obstruction of terminal part of common biliary duct, were studied. Complications had occurred in 62 (5.7%) patients, bleeding--in 34 (3.1%) of them. All the patients had survived.
Asunto(s)
Colestasis/diagnóstico , Colestasis/cirugía , Enfermedades del Conducto Colédoco/diagnóstico , Enfermedades del Conducto Colédoco/cirugía , Esfinterotomía Endoscópica/métodos , Adulto , Anciano , Anciano de 80 o más Años , Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Colangiopancreatografia Retrógrada Endoscópica/instrumentación , Colangiopancreatografia Retrógrada Endoscópica/métodos , Duodenoscopios , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Esfinterotomía Endoscópica/efectos adversos , Esfinterotomía Endoscópica/instrumentaciónRESUMEN
There is presented tactics of treatment of 1325 patients, in whom choledocholithiasis was diagnosed. In 1023 (7.4%) of them in the first stage endoscopic papillosphincterotomy was performed and transpapillar endobiliary manipulations, in 1-2 days--laparoscopic cholecystectomy. In 302 (2.9%) patients laparoscopic exploration of common biliary duct with cholecystectomy were performed. Intraoperative complications occurred in 28 (2.7%) and postoperative--in 72 (7%) patients. All patients are alive.
Asunto(s)
Colecistectomía Laparoscópica/instrumentación , Colecistectomía Laparoscópica/métodos , Coledocolitiasis/cirugía , Femenino , Tecnología de Fibra Óptica/instrumentación , Humanos , Masculino , Índice de Severidad de la EnfermedadRESUMEN
The results of endoscopic papillosphincterotomy with subsequent endobiliary intervention performance in the clinic in 2235 patients in 2000-2006 yrs were studied up. Early complications had occurred in 113 (5.1%) patients, including hemorrhage--in 57 (50%); late complications--in 64 (2.9%). All the patients are alive.
