Lavrentyeva O. Antegrade endobiliary and endovascular surgery in a complex treatment of hepatopancreatobiliary neoplasms complicated by obstructive jaundice

The research focuses on retrospective and prospective analysis of the outcomes of surgical treatment of 158 patients with malignant neoplasms of hepatobiliary organs, which are complicated by obstructive jaundice, who were treated at “Institute of General and Emergency Surgery named after V.T. Zaitsev of NAMS of Ukraine” (Kharkiv) during 2010-2019. The results obtained indicate that in patients with mechanical jaundice of tumorigenesis, the initial intervention is the unloading of biliary hypertension by antegrade drainage of the intra-hepatic bile ducts. The developed diagnostic-therapeutic algorithm with the use of antegrade endobiliary and endovascular interventions in patients with mechanical jaundice of tumor genesis allows to increase the effectiveness of treatment due to both two-stage and due to the formation of a group of patients in whom the minimally invasive technologies translate inoperable cases into operable ones. The proposed approach of combined use of endobiliary and endovascular minimally invasive interventions in patients with mechanical jaundice of tumor genesis allowed to reduce the number of complications by 18.4%, lethality - by 3.9%, and increase the life expectancy in palliative cases to an average of 9.3 months. Key words: obstructive jaundice, hepatopancreatobiliary tumors, percutaneous transhepatic cholangiodrainage, intra-arterial chemoembolization, radical surgical intervention.