Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 084] SEQUENCE OF CHOOSING TACTICS FOR MINIMALLY INVASIVE TREATMENT OF OBSTRUCTIONAL JAUNDICE OF PARASITIC GENESIS
Farukh MAHMADZODA 1, Abdurahmon ASHUROV 1, Faridun SAFAROV 2, Faridun AZIMOV 1, Davlat SADULLOEV 2, Kamol BAROTOV 1
1 Department of Surgical Diseases №1, Avicenna Tajik State Medical University, TAJIKISTAN, 2 Department of Surgical Diseases №1, State Institution "Institute of Gastroenterology of the Republic of Tajikistan", TAJIKISTAN
Background : Determination of the sequence of choice of tactics for minimally invasive treatment of obstructive jaundice of parasitic origin.
Methods : The study is based on an analysis of 470 patients with liver echinococcosis, operated on during the period 2007-2022. Liver echinococcosis, complicated by obstructive jaundice, was detected in 95 (20.2%) patients. There were 42.3% men, 57.7% women.
Results : 46 (48.4%) patients were hospitalized with a severe icteric form of the disease, a severe clinical picture caused by the formation of a cystobiliary fistula with segmental bile ducts - 28 (29.5%), with a mild course - 22.1%. Endoscopic papillosphincterotomy (EPST), as the first stage of the operation, was performed in 29 (30.5%) patients, including instrumental removal of fragments of the chitinous membrane and daughter cysts of echinococcus. For the purpose of simultaneous decompression of the residual cavity of the hydatid cyst and common bile duct after EPST, nasobiliary drainage was performed. Combined EPST and nasobiliary drainage was used in 11.6% patients. And in 3.1% patients with EC breakthrough into the bile ducts, with the development of parasitic obstructive jaundice, 2-stage minimally invasive interventions were undertaken. The first stage was primary EPST, the second - interventions using the modified PAIR method. In 66.3% patients who, for various reasons, could not eliminate biliary hypertension endoscopically, after appropriate preoperative preparation, traditional operations were performed in a delayed manner. Postoperative complications occurred in 8 (8.4%), deaths – in 3 (3.1%).
Conclusions : Staged combined minimally invasive tactics for the treatment of obstructive jaundice of parasitic origin help improve immediate results.
Methods : The study is based on an analysis of 470 patients with liver echinococcosis, operated on during the period 2007-2022. Liver echinococcosis, complicated by obstructive jaundice, was detected in 95 (20.2%) patients. There were 42.3% men, 57.7% women.
Results : 46 (48.4%) patients were hospitalized with a severe icteric form of the disease, a severe clinical picture caused by the formation of a cystobiliary fistula with segmental bile ducts - 28 (29.5%), with a mild course - 22.1%. Endoscopic papillosphincterotomy (EPST), as the first stage of the operation, was performed in 29 (30.5%) patients, including instrumental removal of fragments of the chitinous membrane and daughter cysts of echinococcus. For the purpose of simultaneous decompression of the residual cavity of the hydatid cyst and common bile duct after EPST, nasobiliary drainage was performed. Combined EPST and nasobiliary drainage was used in 11.6% patients. And in 3.1% patients with EC breakthrough into the bile ducts, with the development of parasitic obstructive jaundice, 2-stage minimally invasive interventions were undertaken. The first stage was primary EPST, the second - interventions using the modified PAIR method. In 66.3% patients who, for various reasons, could not eliminate biliary hypertension endoscopically, after appropriate preoperative preparation, traditional operations were performed in a delayed manner. Postoperative complications occurred in 8 (8.4%), deaths – in 3 (3.1%).
Conclusions : Staged combined minimally invasive tactics for the treatment of obstructive jaundice of parasitic origin help improve immediate results.
SESSION
E-poster
E-Session 03/21 ALL DAY