RETROGRADE ENDOSCOPIC INTERVENTIONS IN OBSTRUCTIVE JAUNDICE MANAGEMENT

Aim. To determine the effectiveness of endoscopic transpapillary techniques in diagnosis and treatment of patients with obstructive jaundice of various origin.

Materials and Methods. We analyzed the effectiveness of endoscopic diagnosis and treatment of patients with obstructive jaundice for the period 2008–2012. The total number of patients was 900. Patients with mechanical obstacle for bile outflow and bilirubin level over 20 mmol/l were included. We used retrograde cholangiopancreatography (ERCP), endoscopic papillotomy (EPT), endoscopic mechanical lithotripsy and lithoextraction (EMLE, EMLT), nasobiliary drainage (NBD), probing and stenting of bile ducts, endoscopic contact electrohydraulic lithotripsy, balloon dilatation of the common bile duct.

Results. Interventions were effective in 874 patients (97.11%). Complications occurred in 31 patients (3.44%). Mortality was absent.

Conclusion. Endoscopic transpapillary interventions are highly effective in patients with obstructive jaundice. Instrumental hardware equipment and complex application have a great importance in this case.

1. Borisova N.A., Borisov A.E., Kareev A.E. Jendobiliarnye metody korrekcii mehanicheskoj zheltuhi [Endobiliary methods of obstructive jaundice correction]. Guidelines for surgery of the liver and biliary tract ed. Borisov A.E. St. Petersburg: Scythia, 2003; 2: 254–281. (In Russian)

2. Vetshev P.S. Diagnostic approach to obstructive jaundice. Rossijskij zhurnal gastrojenterologii, gepatologii, koloproktologii. 1999; 6: 12–16. (In Russian)

3. Yarema I.V., Shevchenko V.P., Sergeyko A.A. Some aspects of endoscopic diagnosis and treatment of nonneoplastic obstructive jaundice. Abstracts of the 2nd All-Russian Congress on Endoscopic Surgery. Endoskopicheskaia khirurgiia. 1999; 2: 79–80. (In Russian)

4. Blokhin N.N., Itin A.B., Klimenko A.A. Rak podzheludochnoj zhelezy i vnepechenochnyh zhelchnyh protokov [Pancreatic and extrahepatic biliary cancer]. Moscow: Medicine, 1982. 270 p. (In Russian)

5. Prudkov M.I., Nishnevich E.V., Amelin M.P. Urgent complications of choledocholithiasis: obstructive jaundice, obstructive cholangitis and acute pancreatitis. Opportunities of complex minimally invasive surgery. Endoskopicheskaia khirurgiia. 2002; 3: 47. (In Russian)

6. Kharnas S.S., Sinitsyn V.E., Shekhter A.I. Diagnostic approach to obstructive jaundice complicated by suppurative cholangitis. Khirurgiia. 2003; 6: 36–41. (In Russian)

7. Balalykin A.S. Jendoskopicheskaja abdominal'naja khirurgija [Endoscopic abdominal surgery]. Moscow: Medicine, 1996. 152 p. (In Russian)

8. Gallinger Yu.I., Khrustaleva M.V., Shatveryan D.G., Amelina M.A., Yusupov Kh.I. Neotlozhnoe transpapilljarnoe zhelche otvedenie u bol'nyh s obstruktivnoj zheltuhoj razlichnoj jetiologii [Emergency transpapillary biliary drainage in patients with obstructive jaundice of various etiology]. Current issues of emergency endoscopy. Abstracts of the 1st All-Russian scientificpractical conference. St. Petersburg, 2010. P. 81–82. (In Russian)

9. Сomplications of ERCP (The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy). Gastrointest. Endosc. 2012; 75 (3): 467–473. doi: 10.1016/j.gie.2011.07.010.