COMPREHENSIVE MANAGEMENT STRATEGY FOR PATIENTS WITH CHOLEDOCHOLITHIASIS: DIAGNOSTICS, MINIMALLY INVASIVE TREATMENT, AND SURGICAL RISK PREDICTION

सार

The monograph presents current data on the technical aspects of performing minimally invasive and open (laparotomic) interventions for chronic benign biliary obstruction (CBBO), as well as developed strategic approaches to the selection of treatment methods.

Based on the analysis of the diagnostic performance of various imaging modalities (ultrasound, multislice computed tomography (MSCT), magnetic resonance imaging (MRI), magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound (EUS), etc.), the diagnostic value of each modality has been уточнено and a rational sequence for their use in clinical practice has been established.

The importance of the integrated use of preoperative and intraoperative diagnostic methods is demonstrated, including the application of the authors’ method entitled “A method for determining the localization and extent of biliary outflow obstruction in the common hepatic or common bile duct,” which improves diagnostic accuracy and enables a well-founded choice of surgical strategy.

The high diagnostic value of MRCP and EUS as alternatives to invasive techniques (endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC)) is substantiated.

Diagnostic algorithms for CBBO and schemes for the differential diagnosis of obstructive jaundice have been developed.