Minimally invasive treatment of bile leakage in pancreatobiliary surgery

Abstract

jaundice and hepatic failure, increasing complications and recovery cost. Methods: 28 (6.1%)of 462 patients with LHD had cyst's burst into biliary tree in age 22-62. The standard exams consisted from general examination, blood analysis, blood biochemical tests supplemented with enzyme linked immune assay (ELISA), as well as retrograde pancreatocholangiography (RPCG). In 20 (72%) cases after EPST it has been done an extraction of chitin coat and elimination of mechanical block with biliary tract lavage. Further all these patients were performed a postponed opened operation. In 8 (28%) cases the attempts of chitin coat removal were not successful, patients were urgently operated. Results: The sensitiveness of ELISA method was about 96.3%. In 20 of 28 patients (71.4%) we have reached total elimination of mechanical obstacle by EPST with decreasing of bilirubine at day 6-7. 8 patients (29.6%) with unsuccessful attempts, have been operated afterwards, and bilirubin level got to normal at postoperative day 11-12. Conclusion: Thus, the complex approach including RPCG is not only high-specific diagnostic method, but also is the treatment one, and allows to eliminate mechanic jaundice, to adequately clean bile ducts, and diminishing the risk of complications.