Staged treatment
Through a mature canal, manipulations are safe and almost painless: the surgeon passes the stricture along a guide, installs an internal-external drainage or a self-expanding stent, and contrasts the ducts to control patency. Indications: planned stage after primary PCHS, migration or occlusion of drainage by bile salts, need for replacement every 3–6 months for palliative drainage. The procedure is outpatient or with one day of observation; After internal prosthetics, the external drainage is removed, the quality of life improves significantly.
Indications
- stones of the common bile duct (choledocholithiasis) with jaundice, cholangitis, pancreatitis;
- obstructive jaundice due to tumors of the head of the pancreas, ducts, and porta hepatis;
- duct strictures, the need for their drainage and prosthetics;
- preparation for radical surgery or palliative bile diversion.
Minimally invasive duct treatment
Duct stones and obstructive jaundice are today treated without large incisions: retrograde through the duodenum (endoscopic papillosphincterotomy with lithotripsy and stone extraction) or antegrade through the skin and liver (percutaneous transhepatic cholangiostomy with drainage and stenting of the ducts under ultrasound/X-ray control). The choice depends on the level and cause of the block, the anatomy and condition of the patient; The techniques complement each other and are often combined with subsequent cholecystectomy or radical surgery.
Benefits of laparoscopy
Laparoscopic access is the standard of modern abdominal surgery: instead of a 10–20 cm incision, 3–4 punctures are left, the pain after surgery is much less, the patient gets up on the day of surgery and is discharged after 1–2 days, the risk of wound infection, hernias in the scar and adhesions is several times lower, and the enlargement of the camera allows you to operate more accurately. In the clinics below, operations are performed by surgeons with extensive laparoscopic experience; hospital (SKD) is included in the price according to the price list.
