[Integration of ICG-fluorescence cholangiography into the safety system of laparoscopic cholecystectomy]. / Integratsiya ICG-fluorestsentnoi kholangiografii v sistemu bezopasnosti laparoskopicheskoi kholetsistektomii.

THE AIM OF THE STUDY: Is evaluating the possibility of integrating ICG-fluorescent cholangiography into the general safety system for laparoscopic cholecystectomy to prevent damage to the extrahepatic bile ducts by working out the methodological aspects of navigation technologies. MATERIALS AND METHODS: The analysis of literature data on various approaches to improve the perioperative identification of anatomical structures during laparoscopic cholecystectomy, including the ICG-fluorescent cholangiography, was carried out. This program was implemented during the provision of elective surgical care to 24 patients with cholelithiasis who underwent laparoscopic cholecystectomy with ICG-fluorescent navigation. RESULTS AND DISCUSSION: The developed program included: preoperative assessment of the anatomy of the biliary tree using MRCP; intraoperative technique of safe laparoscopic cholecystectomy with mandatory application of the concept of «critical view of safety¼ (CVS), which allows the most effective identification of the necessary anatomical structures; the use of ICG-fluorescent cholangiography, which allows to improve the control of anatomical structures at all stages of the operations. CONCLUSIONS: The first experience of using ICG-fluorescent cholangiography testifies to the high informative value of the method, the possibility and prospects of integrating the technology into a comprehensive safety system during laparoscopic cholecystectomy.

[CLINICO-ANATOMICAL EVALUATION OF MIRIZZI SYNDROME].

Presentation of diagnostic capabilities of Mirizzi syndrome in a surgical hospital given its pathological anatomy. Were analyzed 70 case-records of patients with different types of Mirizzi syndrome who were sorted out to groups, relying on extended classification, comprising 6 types. The advantages and disadvantages of diagnostic methods used in Mirizzi syndrome were examined. The evaluation of output data of a number of diagnostic studies promotes concretization of diagnosis. When uninformative results of ultrasound is received the performance of additional diagnostic procedures is necessary. Differential diagnosis between inflammation and cancer of the extrahepatic biliary tract is a complex task. Choosing a less traumatic and dangerous reconstructive surgery depends on the results of preoperative diagnosis.