Subject(s)
Anastomosis, Surgical/methods , Cholecystectomy , Cholecystitis/surgery , Cholelithiasis/complications , Common Bile Duct , Intraoperative Complications , Aged , Cholecystectomy/adverse effects , Cholecystectomy/methods , Cholecystitis/etiology , Cholecystitis/physiopathology , Common Bile Duct/injuries , Common Bile Duct/physiopathology , Common Bile Duct/surgery , Female , Humans , Iatrogenic Disease , Intraoperative Care/methods , Intraoperative Complications/diagnosis , Intraoperative Complications/physiopathology , Intraoperative Complications/surgery , Postoperative Period , Treatment OutcomeABSTRACT
The study, which included data of 226 patients with the obstructive jaundice, proved, that the clinical presentation and laboratory tests have secondary role in diagnosing the level of the biliary block. Among diagnostic means of detecting the etiology of the obstruction were the ultrasound investigation (n=268); the magnetic resonance cholangiopanreatography (n=143); the multispiral computed tomograpth (n=119); the endoscopic retrograde cholangiopanreatography (n=187) and the transcutaneous transhepatic cholangiopanreatography (n=69). Flaws and pros of all the methods were thoroughly analyzed. The endoscopic (n=172) and transcutaneous transhepatic cholangiostomy (n=87) were used for biliary decompression. The comparative analysis of both diagnostic and treatment means allowed the creation of 3-stage algorithm. The efficacy of the last for patients with the obstructive jaundice was 96%.
