TACTICAL QUESTIONS OF LAPAROSCOPIC AND MINI-INVASIVE INTERVENTION AT GALLSTONE DISEASE

Aim. Development of treatment management and estimation of direct results at application of laparoscopic and endoscopic methods of treatment of gallstone disease.

Material and methods. 1143 patients with calculary cholecystitis and 196 patients — with choledocholitiasis and their complications were operated In the department of surgery of organs of digestion of theInstitute ofGastroenterology of NAMS of Ukraine for period 2010–2014.

Results of researches. The instrumental methods of co- and intraoperative control are inculcated the states of hepatopancreatobiliary zone, one-step and two-step laparosсopic, transapillary and endobiliary interferences at choledocholitiasis. Sphincter-saving operation for patients with choledocholitiasis made up 28.1%. Complications took place in 15 (1.1%) patients: bleeding in an abdominal region — 7, bile leakage — 6, paratherapeutic damage of gepaticus — 2. There were no lethal cases.

Conclusions. Surgery of patients with a gallstone disease and choledocholitiasis with the use of laparoscopic one or two-stage management on the basis of sphincter-saving operation and mini-invasive puncture-draining operation improved results of treatment in 96% cases.