Antegrade Transhepatic Papillodilatation and Gall Stone Dislocation into Duodenum in Cholelitiasis
https://doi.org/10.16931/1995-5464.2015331-36
Abstract
Aim. Improvement of cholelitiasis surgical management effectiveness.
Material and Methods. Antegrade transhepatic papillodilatation and dislocation of bile stones into duodenum were performed in 22 patients with cholelitiasis and stones size not more than 10–12 mm via percutaneous transhepatic or transvesical approach. Percutaneous transhepatic approach was used also in case of external common biliary duct drainage (T-tube) presence. Papillodilatation was realized by balloon catheters with diameter 8–14 mm, length 4–6 сm and working pressure 2–6 atm and intrapapillary exposure about 5 minute. Bile duct stones were dislocated using distent endobiliary balloon sliding along transpapillary introduced conductor or between bile duct wall and partially distent balloon.
Results. Antegrade transhepatic balloon papillodilatation and dislocation of bile duct stones into duodenum were successfully realized in 22 patients. Postoperative mortality was absent. Transitory amylazemia was diagnosed in 9 patients. There were no severe complications.
Conclusion. Antegrade transhepatic balloon papillodilatation and lithoextraction is effective and safe method of cholelitiasis surgical management in case of ineffectiveness or inability of traditional retrograde endoscopical technique.
About the Authors
O. I. Okhotnikov
Chair of Surgical Diseases of Faculty of Post-qualifying Education of Kursk State Medical University, Health Ministry of the Russian Federation; Kursk Regional Clinical Hospital
Russian Federation
Russian Federation
Doct. of Med. Sci., Professor of Chair of Surgical Diseases, Faculty of Post-qualifying Education, Kursk State Medical University; Head of X-ray Surgical Department №2, Kursk Regional Clinical Hospital
S. N. Grigoriev
Kursk Regional Clinical Hospital
Russian Federation
Russian Federation
Cand. of Med. Sci., Head of the Department of Suppurative Surgery, Kursk Regional Clinical Hospital, Surgeon at the X-ray Surgical Department №2, Kursk Regional Clinical Hospital
M. V. Yakovleva
Chair of Surgical Diseases of Faculty of Post-qualifying Education of Kursk State Medical University, Health Ministry of the Russian Federation; Kursk Regional Clinical Hospital
Russian Federation
Russian Federation
Cand. of Med. Sci., Associate Professor at the Chair of Surgical Diseases, Faculty of Post-qualifying Education, Kursk State Medical University; Surgeon at the X-ray Surgical Department №2, Kursk Regional Clinical Hospital
V. I. Pakhomov
Kursk Regional Clinical Hospital
Russian Federation
Russian Federation
Surgeon at the X-ray Surgical Department №2, Kursk Regional Clinical Hospital
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Review
For citations:
Okhotnikov O.I., Grigoriev S.N., Yakovleva M.V., Pakhomov V.I. Antegrade Transhepatic Papillodilatation and Gall Stone Dislocation into Duodenum in Cholelitiasis. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2015;20(3):31-36. (In Russ.) https://doi.org/10.16931/1995-5464.2015331-36
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