Arutyunov S. Differentiated approach to the choice of minimal invasive technologies at choledoholithiasis and big duodenal papilla stenosis considering the disordered duodenal conduction.

Object of the study: тhe object is cholelithiasis complicated with choledocholithiasis and main duodenal papilla stenosis. Purpose of the study: elaboration and introduction differentiated approach to the choice of minimal invasive technologies at choledoholithiasis and big duodenal papilla stenosis considering the disordered duodenal conduction. Methods of the investigation: clinicaly, tool and statistical; Theoretical and practical results:stady of the patients with cholelithiasis complicated correlation chronic disordered duodenal conduction and pathology of hepati-cocholedoch and big duodenal papilla. The medical-diagnostic algorithm with wide usage of differentiated approach to the choice of minimal invasive interventions of sphincter-preserving technologies transpapillar sphincter-preserving endoscopic interventions. Novelty: gradient determination has been grounded pressure of choledoch and duodenal use monitoring of the patients with choledocholithiasis and main duodenal papilla stenosis, thatallows to confirm the presence of chronic duodenal conduction disorders with determination of predisposition to the duodenocholedocheal reflux development to chose the rational surgical tactics use minimal invasive interventions usage transpapillar sphincter-preserving endoscopic interventions.On the base of clinical-biochemi and microbiological research the value of the usage is the patients with cholangitis nasobiliar drainage with improved probe studied. Degree of introduction: the suggested methods of the diagnosis and treatment were introduced into the work Kharkiv City clinical Hospital of emergency and urgent medical aid named after Prof. A.I. Meshchaninov, of the Institute general and urgent surgery Academy of Medical Sciences of the Ukraine, Kharkiv City Hospital No 2. Sphere of application: medicine, surgery.