title: [The surgical tactics of treatment of the choledocholithiasis, complicated by the obstructive jaundice, in patients with the altered bilioduodenal anatomy].
abstract: The treatment results of 69 patients with the altered bilioduodenal anatomy and choledocholithiasis, complicated by the obstructive jaundice, were analyzed. The anatomic changes were determined by the previous gastric resection or gastrectomy, biliodigestive anastomosis, bile duct strictures, pyloric stenosis, duodenal diverticulum or the Mirizzi syndrome. The surgical approach depended on the type and extent of anatomic changes. The endoscopic common bile duct decompression was possible in 82,6% of patients. The endoscopic bile duct stone removal was achieved only in 44,9% of patients, the other 8,7% with non-removable stones had the endoscopic bile duct stenting as a means of palliative surgery. Percutaneous transhepatic lithoextraction was performed in 1,5% of cases. The differential approach provided the decrease of postoperative complication rate and lethality to 14,5 and 2,9%, respectively.
authors.forename: S G
authors.initials: SG
authors.lastname: Shapoval'iants
authors.forename: T B
authors.initials: TB
authors.lastname: Ardasenov
authors.forename: E D
authors.initials: ED
authors.lastname: Fedorov
authors.forename: A G
authors.initials: AG
authors.lastname: Myl'nikov
authors.forename: A G
authors.initials: AG
authors.lastname: Pan'kov
authors.forename: S A
authors.initials: SA
authors.lastname: Budzinskiĭ
authors.forename: E V
authors.initials: EV
authors.lastname: Ivanova
authors.forename: A N
authors.initials: AN
authors.lastname: Bachurin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001649:Bile Duct Diseases / Q000150:complications / Q000503:physiopathology; D042883:Choledocholithiasis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods; D004378:Duodenal Diseases / Q000150:complications / Q000503:physiopathology; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D015607:Stents; D016896:Treatment Outcome