METHOD FOR REMOVAL OF LARGE WEDGED COMMON BILE DUCT STONES IN COMPLEX CANNULATION Russian patent published in 2024 - IPC A61B17/94 A61M25/01 A61M25/10 A61K31/75 A61K31/35 A61K31/245 A61K9/08 A61B1/273 A61B17/32 A61B17/221 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to hepatobiliary surgery, endoscopy. First stage involves hepatoprotective, anti-inflammatory and antispasmodic therapy. Percutaneous transhepatic cholangiostomy is performed. Common bile duct is washed with 0.25% novocaine. After irrigation, diethyl ether is administered through the cholangiostoma in dose of 15 ml for 30 minutes; the procedure is performed daily for 5 days. After each introduction of diethyl ether, the cholangiostoma is closed with clamp for 30 minutes, then the clamp is removed and the common bile duct is washed from diethyl ether with 0.25% novocaine solution. At the second stage, a conductor is delivered through the cholangiostoma, and a balloon enlargement of the lumen of the terminal portion of the common bile duct is performed. Duodenoscopy is performed, followed by cannulation of the greater duodenal papilla. Stone is pushed into the dilated portion of the common bile duct; an endoscopic papillosphincterotomy is performed; the stone is removed with the help of a Dormia basket and the patency of the common bile duct is restored.

EFFECT: method enables to reduce the size of stone by 20% and has no side effect on the bile ducts, liver, pancreas and duodenum, reduces injuries and probability of bile duct perforation, prevents development of postoperative pancreatitis by using diethyl ether with subsequent balloon dilatation of the duct.

1 cl, 3 ex