Endoscopic surgeries and correction of homeostasis disorders in patients with obstructive jaundice

Abstract

Aim. To improve the treatment results of patients with obstructive jaundice using endoscopic methods for restoring biliary tract patency. Methods. A retrospective analysis of treatment results of 636 patients, treated in the surgical departments of City Clinical Hospital №7, Kazan, Russia in 2004-2014 with obstructive jaundice induced by tumors and other diseases was performed. Results. It was revealed that using endoscopic techniques for biliary system decompression allows to improve the treatment results. Our observations of patients 2014 with obstructive jaundice induced by tumors and other diseases suggest that the most important element of a comprehensive treatment of such patients is the earliest possible biliary tract decompression using minimally invasive approach, including endoscopic papillotomy and biliary tract stenting. The liver failure stage is an important criterion that defines patient management in case of obstructive jaundice. In patients with obstructive jaundice, treatment of endogenous toxemia and liver failure, according to the contemporary approaches, is based on drug administration and infusions of the required volume and contents, associated with one of the methods for biliary decompression therapy adequate in its formula and size. Conclusion. Endoscopic surgeries are indicated in the majority of acute, recurrent, and chronic large duodenal papilla obstruction cases. Performing endoscopic retrograde cholangiopancreatography, endoscopic pancreatic sphincterotomy in obstructive jaundice not associated with biliary tumors may refuse the surgical approach or reduce its volume and surgical injury.