I.M. SAYFUTDINOV, L.E. SLAVINA, A.F. GALIMZYANOV, S.B. SANGADZHIEV, R.R. YAKHIN, A.Z. ZAMALEYEV, A.G. PODSHIVALOV, A.M. BAYTIMIROV

Interregional Clinical – Diagnostic Center, 12a Karbyshev Str., Kazan, Russian Federation, 420101

Sayfutdinov I.M. — Ph. D. (medicine), Head of the Endoscopy Department, tel. (843) 291-10-12, e-mail: [email protected]

Slavin L.E. — D. Sc. (medicine), Professor, Chief Specialist in Surgery, tel. (843) 291-11-43, e-mail: [email protected]

Galimzyanov A.F. — Ph. D. (medicine), deputy Chief Doctor on Organizational Methodological Work, surgeon, tel. +7 (843) 291-10-88, e-mail: [email protected]

Sangadzhiev S.B. — Ph. D. (medicine), surgeon, e-mail: [email protected]

Yakhin R.R. — surgeon, tel. (843) 291-10-88, e-mail: [email protected]

Zamaleyev A.Z. — surgeon, tel. (843) 291-10-88, e-mail: [email protected]

Podshivalov A.G. — surgeon, tel. (843) 291-10-88, e-mail: [email protected]

Baytimirov A.M. — surgeon, tel. (843) 291-10-88, e-mail: [email protected]

To analyze the results of treatment of 37 patients with choledocholithiasis with the developed «Method of endoscopic treatment of choledocholithiasis and prevention of postmanipulation complications» (decision of 9.01.2018 on granting a patent to the application №2016145564).

Material and methods. In 2016–2017, 93 endoplamic surgeries were performed on 10 men and 27 women with an average age of 65 y.o.

Results. Early postoperative complications were not found. Transient amylasemia was observed in 12 patients (32%). Dynamic hepatobiliscintigraphy was performed 3–6 months after the operation in 7 patients. Signs of Oddi sphincter insufficiency were absent in 6 patients (86%).

The conclusion. The elaborated method of endoscopic treatment of choledocholithiasis allows minimizing the risk of postmanipulation complications.

Key words: choledocholithiasis, method of endoscopic treatment, early and late postmanipulation complications, endopapillary interventions.

(For citation: Sayfutdinov I.M., Slavin L.E., Galimzyanov A.F., Sangadzhiev S.B., Yakhin R.R., Zamaleyev A.Z., Podshivalov A.G., Baytimirov A.M. New technologies for safe endopapillar interventions in patients with choledocholithiasis. Practical Medicine. 2018)

 REFERENCES

1. Gabriehlʹ S.A., Dynʹko V.Yu., Golʹfand V.V. et al. Endoscopic transrapillary interventions in the diagnosis and treatment of choledocholithiasis. Fundamentalʹnye issledovaniya, 2012, no. 2, pp. 276–282 (in Russ.).
2. Stupin V.A., Basarbolieva Zh.V., Agapov M.A. The results of the combined treatment of patients with mechanical jaundice of benign genesis. Khirurgiya,2012, no. 7, pp. 75–79 (in Russ.).
3. Batig E.V., Golʹtsov V.R., Savello V.E., Perunova D.N. Features of the treatment of choledocholithiasis in acute biliary pancreatitis. Khirurgiya, 2015, vol. 16, p. 79 (pp. 885–903) (in Russ.).
4. Shapovalʹyants S.G., Ardasenov T.B., Panʹkov A.G. et al. Difficult case of choledocholithiasis — the result of late surgical treatment of cholelithiasis. Rossiyskiy zhurnal gastroehnterologii, gepatologii, koloproktologii, 2013, vol. 23 (4), pp. 15–21 (in Russ.).
5. Korolev M.P., Fedotov L.E., Avanesyan R.G., Khuseynov G.A. Choledocholithiasis in non-standard situations: the possibilities of combined methods of minimally invasive intervention. Vestnik khirurgii imeni I.I. Grekova, 2012, vol. 17 (4), pp. 74–78 (in Russ.).
6. Freeman M.L., Di Sario J.A., Nelson D.B. et al. Risk factors for post-ERCP pancreatitis: a prospective, multicenter study. Gastrointest. Endosc, 2001, vol. 54, pp. 425–434.
7. Masci E., Mariani A., Curioni S., Testoni P. A Risk factors for pancreatitis following endoscopic retrograde cholangiopancreatography: a meta-analysis. Endoscopy, 2003, vol. 35 (10), pp. 830–834.
8. Kahaleh M., Freeman M. Prevention and management of post-endoscopic retrograde cholangiopancreatography complications. Clin. Endosc, 2012, vol. 45, pp. 305–312.
9. Anderson M.A., Fisher L., Jain R. et al. Complications of ERCP. ASGE Standards of Practice Committee. Gastrointest. Endosc, 2012, vol. 75 (3), pp. 467–473.
10. Dumonceau J.M., Andriulli A., Deviere J. et al. European Society of Gastrointestinal Endoscopy (ESGE) Guideline: prophylaxis of post-ERCP pancreatitis. Endoscopy, 2010, vol. 42 (6), pp. 503–515.
11. Tsuchiya T., Itoi T., Sofuni A. et al. Temporary pancreatic stent to prevent post endoscopic retrograde cholangiopancreatography pancreatitis: a preliminary, single-center, randomized controlled trial. J. Hepatobiliary Pancreat. Surg, 2007, vol. 14, pp. 302–307.
12. Kawaguchi Y., Ogawa M., Omata F. et al. Randomized controlled trial of pancreatic stenting to prevent pancreatitis after endoscopic retrograde cholangiopancreatography. World J. Gastroenterol, 2012, vol. 18 (14), pp. 1635–1641.
13. Lazaraki G. Prevention of post ERCP pancreatitis: an overview. Ann. Gastroenterol, 2008, vol. 21 (1), pp. 27–38.
14. Sayfutdinov I.M., Slavin L.E. Preventive and therapeutic measures aimed at reducing transpapillary complications. Prakticheskaya meditsina, 2015, no. 6 (91), pp. 29–33 (in Russ.).
15. Nechitaylo M.E., Ogorodnik P.V., Belyaev V.V. et al. Complications of endoscopic transpapillary interventions. Klinicheskaya khirurgiya, 2006, vol. 8, pp. 19–21 (in Russ.).
16. Bagnenko S.F., Kabanov M.Yu., Yakovleva D.M. et al. Optimization of treatment tactics for patients with cholelithiasis complicated by choledocholithiasis. Vestnik Rossiyskoy voenno-meditsinskoy akademii, 2011, no. 3 (35), pp. 35–42 (in Russ.).
17. Mandryka Y., Klimczak J., Duszewski M. et al. Bile duct infections as a late complication after endoscopic sphincterotomy. Pol Merkur Lekarski, 2006, vol. 21 (126), pp. 525–527.
18. Chan H.H., Lai K.H., Lin C.K. et al. Impact of food on hepatic clearance of patients after endoscopic sphincterotomy. J Chin Med Assoc, 2009, vol. 72 (1), pp. 10–14.
19. Kochhar R., Dutta U., Shukla R. et al. Sequential endoscopic papillary balloon dilatation following limited sphincterotomy for common bile duct stones. Dig. Dis. Sci, 2009, vol. 54 (7), pp. 1578–1581.
20. Neng-Ping Li, Jiang-Qi Liu, Zhi-Qiang Zhou et al. Ampulla dilation with differentsized balloon store move common bile duct stones. World J. Gastroenterol, 2013, vol. 19 (6), pp. 903–908.
21. Aizawa T., Ueno N. Stent placement in the pancreatic duct prevents pancreatitis after endoscopic sphincter dilation for removal of bile duct stones. Gastrointestinal Endoscopy, 2001, vol. 54 (2), pp. 209–213.