Stage interventions in the treatment of patients with malignant diseases of the common bile duct terminal segment complicated by acute mechanical jaundice

  • Stanislav Kosulin Government Institution “V. T. Zaycev Institute of General and Urgent Surgery of National Academy of Medical Science of Ukraine”; State City Hospital No.17; Kharkiv Medical Academy of Postgraduate Education https://orcid.org/0000-0003-0791-0034
  • Juriy Vinnik Government Institution “V. T. Zaycev Institute of General and Urgent Surgery of National Academy of Medical Science of Ukraine”; State City Hospital No. 17 https://orcid.org/0000-0002-8135-0445
  • Julia Ivanova Government Institution “V. T. Zaycev Institute of General and Urgent Surgery of National Academy of Medical Science of Ukraine”; State City Hospital No. 17 https://orcid.org/0000-0001-8773-6827
Keywords: pancreaticoduodenectomy, percutaneous transhepatic cholangio-/cholecystostomy, endoscopic papillosphincterotomy, antegrade and retrograde stenting

Abstract

Obstructive mechanical jaundice is a well-researched complication of various diseases and causes, yet considering patients` condition with malignant diseases according to the stage of the malignant process, severity of complications and etc. Selection of the most appropriate method of surgical treatment is always an option where it is essential to consider finding a way between efficiency and surgical trauma.

The aim of the research is to optimize the results of surgical treatment of patients with malignant tumours of the common bile duct terminal segment complicated by acute mechanical jaundice.

Materials and methods: patients over 18 y.o. with duodenal obstruction; the presence of other active cancer pathology or blood diseases.

The research was performed on 2 different groups divided according to the use of biliary passability restoring method concluding the preferability of minimally invasive methods of bile duct decompression.

Results: minimally invasive methods are not inferior to the effectiveness of biliary decompression comparing to open methods, have a number of advantages, such as minimal invasiveness, relative safety, low incidence of complications and mortality

Conclusions: the introduction of the developed algorithm for surgical treatment of blastomatous mechanical jaundice with the consistent use of antegrade and open methods, as well as antegrade, retrograde and “rendezvous” techniques in surgically incurable patients allowed to reduce the number of early postoperative complications from 32.7 % to 13.3 %, the number of complications requiring surgery – from 5.8 % to 1.3 % and the level of postoperative mortality – from 11.5 % to 2.7 %.

Downloads

Download data is not yet available.

Author Biography

Stanislav Kosulin, Government Institution “V. T. Zaycev Institute of General and Urgent Surgery of National Academy of Medical Science of Ukraine”; State City Hospital No.17; Kharkiv Medical Academy of Postgraduate Education

Department of Oncological Surgery Radiotherapy and Palliative Care

References

Lupaltsov, V. Y. (2013). Sovremennoe sostoianye y perspektyvi otechestvennoi pankreatolohyy. Naukovyi Zhurnal MOZ Ukrainy, 1 (2), 37–46.
Dronov, A. Y., Zemskov, S. V., Kriuchyna, E. A. (2016). Performance of total pancreatectomy for pancreatic malignancies. Klinichna khirurhiia, 10, 26–30.
Giovannini, M., Caillol, F., Monges, G., Poizat, F., Lemaistre, A.-I., Pujol, B. et. al. (2016). Endoscopic ultrasound-guided needle-based confocal laser endomicroscopy in solid pancreatic masses. Endoscopy, 48 (10), 892–898. doi: http://doi.org/10.1055/s-0042-112573
Vetshev, P. S., Kitaev, V. M., Bardakov, V. G. et. al. (2007). Klinicheskie i ekonomicheskie aspekty luchevoy diagnostiki prichin obstruktivnoy zheltukhi. Annaly khirurgicheskoy gepatologii, 12 (3), 49–50.
Dudarev, I. V., Zhdanov, A. I., Dudareva, M. V. (2016). Sostoyanie vrozhdennogo i adaptivnogo pankreatita s razvernutoy kartinoy poliorgannoy nedostatochnosti. Aktualnye problemy i dostizheniya v meditsine, 34–37.
Singh, S., Sachdev, A. K., Chaudhary, A. (2008). Palliative surgical bypass for unresectable periampullary carcinoma. Hepatobiliary & Pancreatic Diseases International, 7 (3), 308–312.
Kubishkyn, V. A. (2009). Periampullary tumors. Pacific Medical Journal, 2, 53–56.
Budzinskiy, S. A., Shapovalyants, S. G., Fedorov, E. D., Mylnikov, A. G., Bakhtiozina, D. V. (2014). Sovremennye vozmozhnosti endoskopicheskogo retrogradnogo protezirovaniya zhelchnykh protokov v razreshenii mekhanicheskoy zheltukhi pri zlokachestvennykh opukholyakh organov pankreatobiliarnoy zony. Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii, 24 (5), 11–21.
Nychytailo, M. Yu., Ohorodnyk, P. V., Deinychenko, A. H., Boiko, O. H., Khrystiuk, D. I., Shalkovska, H. I., Kycha, H. M. (2012). Algorithm of differential and topical diagnosis of obturationjaundice and miniinvasive correction of the main bile divertingpathways passability. Klinichna khirurhiia, 2, 5–10.
Duan, F., Cui, L., Bai, Y., Li, X., Yan, J., Liu, X. (2017). Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis. Cancer Imaging, 17 (1). doi: http://doi.org/10.1186/s40644-017-0129-1
Shabunin, A. V., Lebedev, S. S., Tavobilov, M. M., Bagatelia, Z. A., Grekov, D. N., Karpov, A. A., Afanasieva, V. A. (2021). Preoperative biliary drainage for malignant biliary obstruction: to drain or not to drain? And if drain, in what way? Khirurgiya. Zhurnal Im. N. I. Pirogova, (6), 101–105. doi: http://doi.org/10.17116/hirurgia2021051101
Teterin, Y. S., Tigiev, L. R., Yartsev, P. A., Stepan, E. V., Rogal, M. L., Kulikov, Y. D. (2021). Management of obstructive jaundice in patients with neoplasms of the major duodenal papilla. Khirurgiya. Zhurnal Im. N.I. Pirogova, 7, 49–56. doi: http://doi.org/10.17116/hirurgia202107149
Al-Taan, O. S., Stephenson, J. A., Briggs, C., Pollard, C., Metcalfe, M. S., Dennison, A. R. (2010). Laparoscopic pancreatic surgery: a review of present results and future prospects. HPB, 12 (4), 239–243. doi: http://doi.org/10.1111/j.1477-2574.2010.00168.x
Chen, J., Lin, S., Zhu, Y. Y. (2016). Liver to abdominal area ratio in prognosis prediction in alcoholinduced acute-on-chronic liver failure. Zhonghua Yi Xue Za Zhi, 96 (10), 801–806. doi: http://doi.org/10.3760/cma.j.issn.0376-2491.2016.10.011
Chanchiev, Z. M. (2015). Features of acute liver failure in emergency abdominal surgery. Sovremennye problemy nauki i obrazovaniya, 6, 155.
Shahrokni, A., Saif, M. (2013). Metastatic Pancreatic Cancer: The Dilemma of Quality vs. Quantity of Life. JOP. Journal of the Pancreas, 14 (4), 391–394. doi: http://doi.org/10.6092/1590-8577/1663
Giovannini, M., Caillol, F., Monges, G., Poizat, F., Lemaistre, A.-I., Pujol, B. et. al. (2016). Endoscopic ultrasound-guided needle-based confocal laser endomicroscopy in solid pancreatic masses. Endoscopy, 48 (10), 892–898. doi: http://doi.org/10.1055/s-0042-112573
Addley, J., Mitchell, R. M. (2012). Advances in the Investigation of Obstructive Jaundice. Current Gastroenterology Reports, 14 (6), 511–519. doi: http://doi.org/10.1007/s11894-012-0285-1
Dougan, S. K. (2017). The Pancreatic Cancer Microenvironment. The Cancer Journal, 23 (6), 321–325. doi: http://doi.org/10.1097/ppo.0000000000000288
Eliseev, S. M., Kornilov, N. G., Chikoteev, S. P., Gumerov, R. R. (2010). Obosnovanie khirurgicheskoy taktiki pri obturatsionnoy zheltukhe. Byul. VSNTS SO RAMN, 5 (75), 233–239.

👁 32
⬇ 41
Published
2021-07-30
How to Cite
Kosulin, S., Vinnik, J., & Ivanova, J. (2021). Stage interventions in the treatment of patients with malignant diseases of the common bile duct terminal segment complicated by acute mechanical jaundice. EUREKA: Health Sciences, (4), 34-40. https://doi.org/10.21303/2504-5679.2021.001984
Section
Medicine and Dentistry