Surgical treatment of patients with mechanical jaundice syndrome caused by choledocholithiasis

Abstract

Treatment of patients with mechanical jaundice remains an urgent problem of modern surgery. Approximately in a half of patients the cause of this syndrome is the presence of concrements in the common bile duct. Nowadays there are various variants of choledocholithiasis surgical treatment – open surgery on bile ducts and various variants of endoscopic interventions.Objective: to determine indications for open variants of surgical treatment of the syndrome of mechanical jaundice caused by choledocholithiasis.Material and methods. The work is based on the retrospective analysis of the treatment results of 78 patients with the syndrome of the mechanical jaundice caused by choledocholithiasis. Patients were divided into two groups depending on the way of the mechanical jaundice elimination. The first group included 20 patients who underwent open surgery, and the second group consisted of 58 patients after endoscopic interventions.Results. In the 1st group 4 patients died out of 20 patients, the lethality rate was 20%. In Group II 2 of 58 patients died, the lethality was 3%. The difference in the lethality indexes between the groups turned out to be statistically significant (p = 0,028).Conclusion. Open surgery is indicated in patients with contraindications to pneumoperitoneum application due to the second half of pregnancy or concomitant pathology of the cardiovascular and/or respiratory systems, in unsuccessful attempts to perform endoscopic intervention, and also in concomitant pancreatitis.