METHOD OF SURGICAL TREATMENT OF PATIENTS WITH HEPATICOCHOLEDOCHUS STRICTURE OF VARIOUS GENESIS, DEVELOPED AFTER RECONSTRUCTIVE SURGERIES Russian patent published in 2020 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to hepatosurgery. Hepatico- or bihepaticoanastomosis is formed with a jejunum, at distance of 20–25 cm from the intersected end of jejunum, the proximal end of which is brought under the skin at the edge of the right rectus muscle of the anterior abdominal wall. Percutaneous transhepatic Goetze—Saypol—Kurian draining of the ducts is performed. Drainages are removed 24 months after their installation. In the presence of hepaticocholedochus stricture and signs of cholangitis after removal of drainages draw line 1 mm in diameter, which is fixed to aponeurosis in places of discharge of transhepatic drainages, in the region of the right rectus abdominal muscle and abdominal wall along the midaxillary line on the right, along the drain channel, attaching to the removed drainage, exposing the end of the line. There is a cylinder for dilation of anastomosis, which is performed under pressure of 2 atm. Dilation procedures are repeatedly repeated until stricture is eliminated, which is confirmed by X-ray control. Line is removed in 12 months with no recurrence of hepaticocholedochus stricture and signs of cholangitis. In the presence of recurrent hepaticocholedochus stricture and signs of cholangitis along the line, drainage is performed in the hepatic ducts for continuous irrigation of the ducts with antibiotics, and after elimination of recurrent hepaticocholedochus and cholangitis stricture, drainage and line are removed.

EFFECT: method enables reducing the risk of remote postoperative complications and mortality; avoiding repeated reconstructive surgeries; lower costs when performing the dilation procedure of the anastomosis.

1 cl, 2 dwg, 1 ex