Boyko O. Choice of biliary decompression method at the distal part obturation of the general bile duct of tumoral origin.

In the thesis the comparative analysis of endoscopic and laparotomic decompressive surgical interventions efficacy at the tumoral obstruction in the distal part of general bile duct has been conducted. The endoscopic decompressive interventions was proved to be effective low level invasive method of biliary decompression in preparation patients for the following radical surgery and the best method of final palliative treatment of patients with unresectable tumours. In cases of benign origin tumours of the big nipple of duodenum an endoscopic papillectomy is an effective and safe alternative to laparotomic surgery. Means of transpapillary decompression of bile ducts, an endoscopic biliary stent, the device to install an endoscopic biliary stent and indications for making an endoscopic papillectomy at adenoma of the big nipple of duodenum are worked out, implemented and evaluated. Diagnostic and therapeutic algorithm in patients with obstructive jaundice is worked out and introduced in clinical practice that enables to use diagnostic techniques efficiently and to choose correct decompressive surgical interventions at the tumoral obstruction in the distal part of general bile duct.