Liana Kurmanseitova
Stavropol State Medical University, Russia
Title: Complications of Antegradny Access at the Decompression of Bilious Channels at Patients with Mechanical Jaundice and Ways of their Treatment
Biography
Biography: Liana Kurmanseitova
Abstract
Introduction: Percutaneous transhepatic drainage of the bile duct and its tributaries is performed for the patients who have the unresectable tumor of the hepatoduodenal area with obstruction of biliary system; only when it is not possible to drain by endoscopy due to dramatic pathological changes in the region or low-performance status of the patient. This procedure improves the quality of life and overall survival without changing disease prognosis.
Aim: The aim of the study is the efficacy and safety assessment of percutaneous techniques installation of biliary drainage systems, and differentiate possible complications and there treatment.
Method: From 2014 to 2015, the clinic endoscopic and minimally invasive surgery at Stavropol State Medical University (StSMU) had 112 inpatients with obstructive jaundice. All patients underwent percutaneous transhepatic drainage of the bile duct and its tributaries. Total 128 operations were done. The average patient age was 65.5 years; mean bilirubin level at admission was 253.
Results: We performed 128 operations on patients. In all cases, the biliary system was drained effectively. In 41.4% mounted external drainage, 32% of the external-internal drainage, 4% drainage bilobar, 6.2% bile duct stent, 3.1% “rendez-vous” passage technique of benign strictures of the common bile duct. In 1.5% of cases, after the drainage of the biliary ducts, hemobilia occurred that was resolved conservatively by the change of drainage and washing. In 13.2% of cases of cholangitis after drainage, in all cases, they were treated conservatively. Allergic reaction was observed to the anesthetic 2.3% (three patients). Leakage of bile into the abdominal cavity was seen because of drainage migration in 1.5% (two patients). The lethal outcome of 0.5% (within seven days of observation) and the duration of hospitalization were three days for the early ambulated patients- fast track.
Conclusion: Percutaneous transhepatic drainage of the bile duct and its tributaries is an important alternative to endoscopic drainage. This intervention is shown to extend the lives of patients with malignant stricture with a low level of survival. Treatment of postoperative complications, the antegrade way of interventions in most cases doesn't demand performance of open operations.