[Minimally invasive technologies of lithotripsy and antegrade hydraulic lithoextraction in complex treatment of choledocholithiasis].

OBJECTIVE

To evaluate the effectiveness of minimally invasive technologies of lithotripsy and hydraulic antegrade lithoextraction in complex treatment of choledocholithiasis.

MATERIAL AND

METHODS

In the main group, 74 patients with choledocholithiasis underwent complex treatment with minimally invasive lithotripsy and hydraulic antegrade lithoextraction. In the control group, 177 patients with choledocholithiasis complicated by obstructive jaundice underwent complex treatment without minimally invasive lithotripsy and hydraulic antegrade lithoextraction.

RESULTS

Both groups were characterized by significant decrease of serum bilirubin, markers of cytolysis and cholestasis with regression of clinical manifestations of obstructive jaundice. At the same time, early and delayed postoperative complications were significantly more common in the control group. Most of these complications accounted for interventions through laparotomy such as external drainage of the common bile duct and hepaticojejunostomy. There were no similar procedures in the main group due to the use of minimally invasive technologies of lithotripsy and antegrade hydraulic lithoextraction.

CONCLUSION

Minimally invasive lithotripsy and antegrade hydraulic lithoextraction are safe alternatives to traditional methods of lithoextraction and can be recommended in case of ineffective laparoscopic and retrograde endoscopic lithoextraction.