Mikheev Y. Features of diagnostics and treatment of residual and recurrent cholangiolithiasis

Dissertation is to devoted the improvement of methods of diagnostics and treatment of residual and recurrent cholangiolithiasis. It was found that residual concrements are differed by high presence of cholesterol, and recurrent concrements mainly contain bilirubin conjugates. The deduced discriminate function allows to diagnose residual cholangiolithiasis with probability of 85,7 %, but recurrent one with - 93,3 %. The basic methods of diagnostics of residual and recurrent cholangiolithiasis is ultrasonography and direct x-ray methods of bile duct research. The presence of mucus shell "wrinkles" of common bile duct tuned out to be X-ray cholangitic symptom was firstly described. The use of endoscopic transpapillary interferences is the method of residual and recurrent cholangiolithiasis treatment choice. It is impossible to remove large concrements endoscopically, the nasobiliary draining allows to complete choledocholithotomy the "deaf guysutures" of common bile duct. Offered the methods of diagnostics and surgical treatment of residual and recurrent cholangiolithiasis with the use of minimalinvasion technologies allowed to reduce postoperative complications from 20,4 % to 12,5 %, postoperative lethality from 2,0 % to 0,0 %.