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, Ukraine 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, Ukraine 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, Ukraine 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 %.

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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

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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