TRANSPAPILLARY, MINIINVASIVE AND TRADITIONAL TECHNIQUES IN BENIGN OBSTRUCTION OF THE COMMON BILE DUCT

Background. The problem of diagnosis and treatment of obstruction of the extrahepatic bile ducts is an urgent and challenging task today. Purpose of the study. To carry out a comparative analysis of the results of surgical interventions for violations of the patency of the extrahepatic bile ducts of benign nature and to determine the indications for a certain type of surgery. Material and methods. We analyzed the results of the examination and the outcomes of surgical interventions in 226 patients with benign impaired patency of the extrahepatic bile ducts and signs of biliary hypertension within 25 years. Results. The examination revealed the causes of biliary hypertension accompanied by obstructive jaundice: choledocholithiasis in 169 patients, of these 71 had choledocholithiasis complicated by cicatricial stricture of the terminal part of the common bile duct. Conclusions. Preference should be given to minimally invasive (endoscopic) techniques for resolving cholestasis in biliary hypertension of benign nature. If they are unsuccessful or impossible, choledochoduodenoanastomosis should be formed: technically and functionally the Finsterer and Flerken techniques are preferable. Choledochoduodenoanastomosis leak can be prevented by external drainage of hepaticoholedochus according to Pikovsky.