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Purpose of the study: to conduct a comparative analysis of endoscopic retrograde transpapillary interventions in patients with chronic opisthorchiasis and obstructive jaundice of various etiologies.Material and Methods. The results of treatment of 129 patients with chronic opisthorchiasis and obstructive jaundice of various etiologies who underwent transpapillary interventions to correct bile duct, were analyzed. In order to assess the condition of patients, general clinical methods and a set of laboratory and instrumental methods were used. The study was carried out in two groups, in the first endoscopic drainage of the bile ducts was carried out, in the second – either endoscopic papillosphincterotomy with choledocholitholite extraction, or endoscopic papillosphincterotomy with bougienage of the ducts. Each group of patients was divided into subgroups according to nosology: 1 – diseases of the biliary tract; 2 – oncological diseases of the hepatopancreatic zone; 3 – pancreatitis. Laboratory indicators before and after the application of minimally invasive interventions were compared.Results. The use of various methods of transpapillary interventions normalizes indicators of bilirubin, and aminotransferases in patients by 5–10 days. Endoscopic stenting of the ducts was the method of choice with cancers of the parasitic organs. With concomitant choledocholithiasis, the endoscopic papillosphincterotomy technique with subsequent lithotripsy and lithoextraction were used. Draining operations showed a good efficacy in the treatment of jaundice in the case of impossibility of removing the calculus. Endoscopic papillosphincterotomy with ductal bougienage was the operation of choice for streak tours of the common bile duct. With purulent cholangitis, endoscopic papillotomy with the installation of nasobiliary drainage and subsequent sanitation of the bile ducts was used.Conclusion. The use of endoscopic drainage has proven itself well in patients with obstructive jaundice of tumor etiology, as well as in patients with choledocholithiasis when it is impossible to remove the calculus. This surgery allows for quick normalization of the bilirubin level.

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The problem of treating diseases of the pancreas remains highly relevant. Despite the large arsenal of methods of surgical treatment of this pathology, even the introduction of endoscopic, minimally invasive and organpreserving technologies does not allow us to speak unambiguously about solving the problem. The high incidence of acute and chronic forms of pancreatitis, the frequent occurrence of malignant neoplasms of the pancreas, in which it is not possible to carry out radical operations, determined the need for the use of cryosurgical technologies both for open interventions on the pancreas and for laparoscopic operations. In an experiment on animals, the effectiveness of the use of ultra-low temperatures in the pathology of the pancreas was proved. The developed methods of cryotherapy began to be used in the clinic not only as independent surgical interventions, but also in combined operations with good immediate and long-term results.

The purpose of this work was the need to highlight the significance of the works of Professor Boris I. Alperovich and his students in creating unique cryosurgical instruments and the development of modern cryosurgical operations on the liver and pancreas. The article used documents confirming the priority of the authors in the creation of cryotherapy equipment and methods of cryosurgical treatment of diseases of the liver and pancreas.