THE DRAINAGE OF THE COMMON BILE DUCT IN ACUTE BILIARY CHOLECYSTITIS, COMPLICATED WITH CHOLEDOCHOLITHIASIS

Aim. The aim of the study was to improve the quality of treatment of patients with acute calculous cholecystitis complicated by choledocholithiasis.

Materials and methods. We have developed a drainage for external drainage of the common bile duct in the presence of hypertension in it or cholangitis, which should provide technical simplicity, reliability, handling and reduce the chance of expanding the scope of operations (choledochotomy). We studied 137 patients with acute calculous cholecystitis complicated by choledocholithiasis during 2008–2014. In the I group study (control) 74 patients was performed drainage of the common bile duct by Halsted Pikovsky by a conventional drainage, and in the study group II (basic) 63 — by drainage of own design.

Results. Patients who were operated on laparoscopically, using the proposed drainage allowed in comparison with the conventional drain much faster to reduce the level of bilirubinemia, the size of the common bile duct, which consequently reduced the average duration term of the common bile duct drainage and hospital stay (р<0.05).

Conclusions. The use of the proposed method drainage allows to reduce time to install drainage, prevent complications at the “difficult” anatomical conditions where conventional drainage is difficult to make. In addition, its use contributes to a more rapid decrease of bilirubinemia, a decrease in the average duration of the common bile duct drainage, and the average length of hospital stay.