METHOD FOR MINIMALLY INVASIVE COMBINATION TREATMENT OF CHOLEDOCHOLITHIASIS ACCOMPANYING ATYPICAL POSITION OF MAJOR DUODENAL PAPILLA

摘要

FIELD: medicine.SUBSTANCE: invention can be used in the endoscopic removal of calculi where it is impossible to apply a conventional approach to the major duodenal papilla (MDP). That is preceded by inserting an ultrasound-controlled guide through the common bile duct in the antegrade direction into the duodenal lumen. A loop is brought through an instrumental canal of a duodenoscope. The loop grips the guide and is brought out. A papillotome is brought down along the guide to the MDP and papillotomy is executed. The papillotome is removed. Basket forceps are brought along the guide to perform lithoextraction.EFFECT: method enables avoiding more traumatic abdominal operations and conducting the minimally invasive treatment of the patients in complicated clinical cases where it is impossible to apply a conventional endoscopic approach to the MDP, as well as reducing the period of stay in hospital and the treatment expense, improving the patients' psychoemotional status by implementing the required procedures in the guide which is brought preliminarily under ultrasonic control through the common bile duct into the duodenal lumen in the antegrade direction.5 dwg, 1 ex