Yevsikov B. Improvement of minimally invasive methods of treatment of patients with "complex" choledocholithiasis

There search was carried out on the basis of Regional clinical hospital (Odesa) during 2005-2021 in two stages. Att he first retrospective stage, ananalysis of medical documentation data (search depth of 10 years - from 2005 to 2015) was carried out for the clinical consequences of casesof HL. It has been proven that the main method of treatment remains endoscopic, which, if necessary, is supplemented by additional interventions - stenting (in elderly patients with a high perioperative risk and in those patients who categorically refuse laparoscopic and laparotomy intervention), balloon dilatation of the SPH with mechanical lithotripsy. Before surgical intervention, it is advisable to decompress the biliary tract with the help of the CHSChPDP to reduce the level of cholemia and the associated risks of bleeding and other complications. The created algorithm for choosing treatment tactics in patients with complex choledocholithiasis involves a combination of percutaneous transhepatic drainage of the bile ducts and endoscopic transpapillary interventions followed by the use of laparoscopic operations on the bile ducts, which allows to reduce the number of complications by 1.5 times and improve the quality of life. According to the GSRS questionnaire, the prevalence of dyspeptic, pain and reflux syndromes in the main group was 3.3 times lower than in the comparison group.