Khilko Y. Comparative evaluation of laparoscopic and endoscopic methods of biliary decompression of periampullary zone tumours

The work is a comprehensive scientific study of the evaluation of the effectiveness of laparoscopic and endoscopic methods of decompression of the biliary tract in tumors of the periampullary zone, as a result of which new scientific data were obtained: it has been scientifically proven that palliative endoscopic and laparoscopic decompression of the common bile duct in patients with inoperable tumors of the periampullary zone in the early postoperative period is accompanied by a statistically significant decrease in hepatodepressive, cytolytic and cholestatic syndromes; it was identified that in the remote period (3 and 6 months) after palliative endoscopic decompression of the common bile duct in patients with inoperable tumors of the periampullary zone, there is a statistically significant, repeated deterioration of parameters of the functional state of the liver, cytolysis and cholestasis; it was proved for the first time that among the reasons for the lower efficiency of palliative endoscopic decompression is the increase in the frequency of late postoperative complications. As a result of scientific research, the following methods of forming laparoscopic hepaticojejunal anastomosis have been developed and implemented in the practical activities of healthcare; method of treatment of proximal migration of a plastic endobiliary stent; method of treatment of plastic endobiliary stent obturation; diagnostic and treatment algorithm for choosing the optimal method of palliative decompression of the common bile duct in patients with inoperable tumors of the periampullary zone.