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POSSIBILITIES OF LAPAROSCOPIC CHOLEDOCHOLITHOTOMY.

Useinov Eldar Bekirovich, Prof. Kostyrnoy Alexander Vasilievich, Kerimov Enver Yakubovich, Statsenko Nataliya Ivanovna

In this article is considered the treatment of 51 patients with choledocholithiasis. Of these, 45 (88.2%, n = 51) patients were underwent a one-stage laparoscopic cholecystectomy, with choledocholithotomy. In 4 cases, when using choledochoscopy, after removing stones from the duct, a blind suture of the common bile duct was overcasted without drainage. In 6 cases of residual choledocholithiasis, choledocholithotomy with drainage of the common bile duct was performed. In cases of choledoch drainage 28 (54.9%, n = 51) patients were performed by drainage through the stump of the cystic duct, 19 (37.3%, n = 51) patients through the choledochotomy opening in the distal direction. In the postoperative period, bile leakage was developing in 5 (9.8%, n = 51) cases. Bile leakage occurred in patients with choledoch drainage through the choledochotomy opening and stopped conservatively in the period from 3-4 days to 2 weeks. In one case, on the second day after the operation, biliary peritonitis developed due to loss of choledoch drainage, which required relaparoscopy, sanation and drainage of the abdominal cavity, recholechostomy. In 3 (5.9%, n = 51) patients with multiple choledocholithiasis in the postoperative period after performing fistulogarfia, single left calculi were revealed in the common bile duct. In this connection, in both cases an endoscopic papillosphincterotomy and lithoextraction were required, and in one case a repeated laparoscopic choledocholithotomy was performed 2 months after the first operation. Successful laparoscopic choledocholithotomy can improve the postoperative period and DECREASE hospitalization. Key words: choledocholithiasis, laparoscopic choledocholithotomy, choledochoscopy, drainage of the common bile duct, balloon dilatation of the duodenal papilla.

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