Volyk A. Diagnostics, surgical treatment and profilactiсs after cholecystectomy caused by chronical duodenal obstruction syndrome

253 patients with chronic calculosous cholecystitis (CCC) and 86 patients with postcholecystectomic syndrome (PHES), caused by chronical duodenal obstruction syndrome (CDOS) were observed. CDOS of functional (70 %) and mechanical (30 %) genesis followed by duodenogastric reflux and athrophic (47 %) or hyperplastic gastritis (53 %) were revealed in number of 50,2 % patients with CCC . The developed techique of optical controlled biopsy raises accuracy of diagnostics of reflux-gastritis on 21 %. After cholecystectomy CDOS are kept at 53 % of patients, and at 35 % are progressing. Simultaneosly CDOS correction with cholecystectomy according to the indications developed by us, eliminates them at 90 % of patients, at 10 % they regress. At case of mechanical CDOS the operation of Strong are indicated or operation of Robinson; functional - operation of Bortolotti. Developed techniques of operation Strong and Bortolotti with the help of laparoscopic technique don't concede to traditional technics. At PHES caused by decompensation of CDOS operation are indicated: duodenojejunostomy during mechanical genesis; excluding the duodenum from the digestion for functional.