Goman A. Prevention, diagnosis and treatment of minor bile duct injury during laparoscopic cholecystectomy

The dissertation is devoted to the prevention, diagnosis and treatment of bile leaks as a result of minor bile duct injury during laparoscopic cholecystectomy. The work proved efficacy of mini-invasive techniques such as endoscopic endobiliary interventions, ultrasound-guided transcutaneous interventions and relaparoscopiesin the treatment of the patients with minor bile duct injury during laparoscopic cholecystectomy. Therapeutic and diagnostic algorithm using mini-invasive techniquesfor patients with bile leakswere designed.Indications for papillosphincterotomy, endobiliary stenting depending on the discharge of bile and the patient's condition were designed. It has been proven that relaparoscopy is effective in patients with bile peritonitis and is better than laparotomy. In order to diagnose choledocholithiasis, which is an important cause of biliary hypertension and postoperative bile leakendosonography wasapplied. It has been proven high accuracy of this method, developed diagnostic algorithms for patients with cholelithiasis. Application endosonography improves the accuracy of diagnosis and exclude using diagnostic endoscopic cholangiography. Such approach reduces the number of complications and material costs.