Bile duct injuries and systemic approach to the treatment
https://doi.org/10.16931/1995-5464.2019171-82
Abstract
Aim. Present a program of examination and treatment of patients with biliary duct injury, corresponding to the level of the international protocol and modern requirements for the quality of medical care.
Material and methods. The results of examination and treatment of 77 patients with bile ducts injuries are analyzed. The analysis of the main surgical interventions for the elimination of bile ducts injuries is given: reconstructive operations in 44.3% of patients, recovery operations – in 36.7% and external drainage – in 19%.
Results. A program approach has been developed to assist patients with bile duct injuries in civil health care at various levels of surgical care.
Conclusions. The implementation of this program provides timely diagnosis of damage to the bile duct and minimizing the number of postoperative complications at the second and third levels of surgical care. It was determined that a rational approach to reduce the number of injuries of the bile ducts is their prevention by perfect adherence to the technique of surgical intervention on the organs of the upper floor of the abdominal cavity, and to reduce the number of negative consequences, the proposed algorithm for diagnosis and treatment.
About the Authors
P. N. Romashchenko
Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Pavel N. Romashchenko – Doct. of Med. Sci., Professor, Corresponding-Member of RAS, Head of the Fedorov Chair and Clinic of Faculty-Based Surgery
6, Akad. Lebedeva str., St. Petersburg, 194044. Phone: +7-812-2923485, +7-911-210-89-90.
N. A. Maystrenko
Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Nikolay A. Maystrenko – Doct. of Med. Sci., Professor, Academician of RAS, Professor of the Fedorov Chair of Faculty-Based Surgery
6, Akad. Lebedeva str., St. Petersburg, 194044.
A. S. Pryadko
Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation; Leningrad Regional Clinical Hospital
Russian Federation
Russian Federation
Andrey S. Pryadko – Cand. of Med. Sci., Assistant of the Fedorov Chair of Faculty-Based Surgery, 6, Akad. Lebedeva str., St. Petersburg, 194044; Deputy Chief Physician for Surgical Care, 45-49, Lunacharskogo Ave., St. Petersburg, 194291.
A. K. Aliev
Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Arsen K. Aliev – Cand. of Med. Sci., Lecturer of the Fedorov Chair of Faculty-Based Surgery
6, Akad. Lebedeva str., St. Petersburg, 194044.
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Review
For citations:
Romashchenko P.N., Maystrenko N.A., Pryadko A.S., Aliev A.K. Bile duct injuries and systemic approach to the treatment. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2019;24(1):71-82. (In Russ.) https://doi.org/10.16931/1995-5464.2019171-82
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