[Current problems of diagnosis and treatment of choledocholithiasis].
The article gives an estimation of a number of diagnostic methods of examination, modes of intraoperative revision of the ducts, means of finishing the operations. The endoscopic retrograde cholangiopancreatography is highly estimated as revealing the stones before the operation in 96% of cases in patients with jaundice and a post-cholecystectomy syndrome. The importance of a certain sequence of using the methods of intraoperative diagnosis (such as cholangiography and cholangiodebitometry--before choledochotomy; choledochoscopy, instrumental revision of the duct and control cholangiography--after choledochotomy) is stressed. The authors are against the tight suture of the common bile duct and show advantages of T-shape drains for the external drainage. The development of methods of non-operative removal of the retained stones with the external drainage of the ducts being present allows sharp restriction of indications for creating biliodigestive anastomoses for multiple stones in the common bile duct.
D002758:Cholangiography / Q000379:methods; D004322:Drainage / Q000379:methods; D042882:Gallstones / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care; D013536:Suture Techniques
Aktual'nye voprosy diagnostiki i lecheniia kholedokholitiaza.