METHOD FOR BILE DUCT STENTING IN PATIENTS WITH MECHANICAL JAUNDICE OF TUMOR ETIOLOGY USING ACCESS THROUGH CHOLECYSTOSTOMY

摘要

FIELD: medicine. ;SUBSTANCE: invention relates to medicine, namely to hepatobiliary surgery. The stent is implanted according to the “Rendezvous” method. An introducer is installed along the conductor into the gallbladder to the mouth of the cystic duct, through which a manipulative catheter “Cobra” is installed into the cystic duct, cholangiography is performed. Then the recanalization of the cystic duct and catheterization of the choledochus are carried out. With the help of the “hydrophilic conductor plus hydrophilic catheter” system, recanalization of the tumor stricture is performed. After penetration behind the stricture area, a conductive catheter is installed. An endoscopic conductor is inserted through the catheter, which is captured through the endoscope with endoscopic forceps and removed through the mouth. Perform a papillosphincterotomy on the conductor. Catheterization of hepaticocholedoch is performed. Hepaticocholedoch stenting is performed with stent implantation, while the proximal end of the stent is installed above the tumor stricture by 20 mm, the distal end is installed transpapillarly into the duodenum. A control drainage catheter is inserted into the gallbladder. After 1 day, a control cholangiography is performed, the patency of the stent is evaluated, the absence of congestion. After 2-3 days, the drainage catheter is removed. ;EFFECT: method is minimally invasive, provides adequate, often lifelong decompression of the biliary tract in patients with inoperable tumors of the hepatopancreatoduodenal zone, to increase the effectiveness of treatment and improve the patients’ life quality. ;1 cl, 3 dwg