Ранние билиарные осложнения панкреатодуоденальной резекции

Проведен обзор современных зарубежных публикаций, посвященных ранним билиарным осложнениям панкреатодуоденальной резекции. Поиск работ осуществляли по ключевым словам на английском языке, использовали платформу PubMed. Всего найдено 127 публикаций, в обзор включено 29. Рассмотрены эпидемиология, классификация ранних билиарных осложнений панкреатодуоденальной резекции, современные взгляды на патогенез, профилактические мероприятия, лечебно-диагностическая тактика. В раннем послеоперационном периоде возможны транзиторная желтуха, холангит, ранние стриктуры и несостоятельность гепатикоеюноанастомоза. Частота их варьирует от 3 до 24% и зависит от эпидемиологических особенностей популяции, особенностей статистического учета и сочетанных состояний. Описан ряд пациент-зависимых факторов риска, а также факторы, обусловленные хирургическими аспектами. Предложен целый ряд эффективных процедур для диагностики и устранения ранних билиарных осложнений, которые можно безопасно применять при ограниченных возможностях эндоскопических манипуляций и ревизионных вмешательств. Своевременная диагностика и лечение позволяют избежать тяжелого течения ранних билиарных осложнений и повторных вмешательств, сохранять медицинские и финансовые ресурсы и обеспечивать благоприятный прогноз.

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