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THE METHODS OF CHOLEDOCHOLITHIASIS TREATMENT

https://doi.org/10.20538/1682-0363-2015-4-99-109

Abstract

The methods of choledocholithiasis treatment, which are currently used in clinics of the Russian Federa-tion, has been presented. The problems of diagnosis and treatment of gallstones (GSD) in individuals of different age groups are spotlighted. In the study of treatment of cholelithiasis and choledocholithiasis, including arising complications, it can be concluded that so far the ideal method of treatment of this pa-thology has not been found. Up to now, the majority of doctor’s main treatment is surgical removal of gall stones by some method or other.

This article also considers a conservative approach (drug: antispasmodics (selective and nonselective), and non-pharmacological: treatment, diet), describes the criteria and assessment of the effectiveness of therapeutic interventions that help in the question of further treatment: the continuation of drug therapy or assignment of surgical treatment. Invasive techniques that are covered in the article, namely, a tech-nique of remote and endoscopic lithotripsy, are high-tech and in demand at the moment, which, along with high efficiency removal of a stone, reduced the number and severity of postoperative complications. Additionally, in the analysis of the features of a particular method of treatment, advantages and disadvantages of different treatment methods are described, indications and contraindications (absolute and relative) together with complications, possible outcomes, and further prognosis are high-lighted. 

About the Authors

N. V. Merzlikin
Siberian State Medical University, Tomsk
Russian Federation
Merzlikin Nikolay V.


V. F. Podgornov
Tomsk Regional Clinical Hospital, Tomsk
Russian Federation
Podgornov Viktor F.


Ye. V. Semichev
Siberian State Medical University, Tomsk
Russian Federation
Semichev Yevgeny V. 


P. S. Bushlanov
Siberian State Medical University, Tomsk
Russian Federation
Bushlanov Pavel S.


V. D. Talacheva
Siberian State Medical University, Tomsk
Russian Federation
Talacheva Vasilya D.


References

1. Sun H., Tang H., Jiang S. et al. Gender and metabolic differ-ences of gallstone diseases. World J. Gastroenterol., 2009, April 21, vol. 15 (15), pp. 1886–1891.

2. Schirmer B.D., Edlich R.F., Winters K.L. Cholelithiasis and cholecystitis. J. Long Term Eff. Med. Implants., v15.i3.90.

3. Dadvani S.A., Vetshev P.S., Shulutko A.M. et al. Zhelchnokamennaya bolezn' [Cholelithiasis]. Moscow, Vidar-M Publ., 2000. 139 p. (in Russian).

4. Ezhev V.N., Valetov A.I., Rudakova M.N., Meshkov V.M. K vyboru taktiki lecheniya holedoholitiaza [The choice of treatment of choledocholithiasis]. Endoskopicheskaya hirurgiya, 2000, no. 6, pp. 13–15 (in Russian).

5. Panpimanmas S., Chantawibul S., Ratanachu-Ek T. Pulse dye laser lithotripsy for large biliary tract stones. J. Med. Assoc. Thai., 2000, vol. 83, pp. 433–438.

6. Vinogradov V.V., Lyutfaliнev A.K. Razrabotki metodov diagnostiki i hirurgicheskogo lecheniнa zabolevaniн pecheni, zhelchevyvodjashhih putej i podzheludochnoн zhelezy. Otchet o NIR No. 0057436 [Development of diagnostics and surgical treatment methods of diseases of the liver, biliary tract and pancreas. Research reports no. 0057436]. Moscow, 1983. 21 p. (in Russian).

7. Gubergric N.B. Zhelchnokamennaya bolezn': ot klassiki k sovremennosti [Cholelithiasis: from classic to contempo-rary]. Gastroenterologiya. Prilozhenie k zhurnalu Consilium Medicum – Gastroenterology. App. to the Journal Consilium Medicum, 2010, no. 1, pp. 83–95 (in Russian).

8. Butov M.A., Shelukhina S.V., Ardatova V.B. K voprosu farmakoterapii disfunkcii biliarnogo trakta [To the question of pharmacotherapy dysfunction of the biliary tract]. Tezisy 5-go s’ezda Nauchnogo obshhestva gastrojenterologov Rossii, 3–6 fevralya 2005 [Abstracts of the 5th Congress of the Scientific Society of Gastroenterologists of Russia, Feb-ruary 3–6, 2005]. Moscow, 2005. Pp. 330–332 (in Russian).

9. Dekhnich N.N. Primenenie sovremennyh spazmolitikov v gastroenterologii [Modern antispasmodics in practice of gas-troenterologist]. Vestnik Smolenskoy gosudarstvennoy medicinskoy akademii – Bulletin of Smolensk State Medical Academy, 2012, no. 2, pp. 64–67 (in Russian).

10. Delyukina O.V. Motornye disfunkcii zhelchnyh putey i osobennosti biohimicheskogo sostava zhelchi pri biliarnom sladzhe, metody ih korrekcii. Dis. kand. med. nauk [Motor dysfunction of the biliary tract and features of biochemical composition of bile in biliary sludge, methods of their cor-rection: Dis. Cand. med. sci.]. Moscow, 2007.

11. Ivashkina V.T. Bolezni pecheni i zhelchevyvodjashhih putey: Rukovodstvo dlya vrachey [Diseases of the liver and biliary tract]. Moscow, M-Vesti Publ., 2002. 416 p. (in Russian).

12. Ilchenko A.A., Mechetina T.A. Diagnostika i lechenie sindroma izbytochnogo bakterial'nogo rosta v tonkoy kishke [Diagnosis and treatment of syndrome of excessive bacterial growth in the small intestine]. Eksperimental'naya i klinicheskaya gastroenterologiya – Experimental & Clinical Gastroenterology, 2010, no. 3, pp. 99–106 (in Russian).

13. Ilchenko A.A. Farmakoterapiya pri zabolevaniyah zhelchnogo puzyrya i zhelchnyh putey [Pharmacotherapy for diseases of the gallbladder and biliary tract]. Moscow, MIA Publ., 2010 (in Russian).

14. Littmann I. Operativnaya hirurgiya. Operacii na zhelchnyh putyah [Operative surgery. Operations on the biliary tract]. Budapest, Publ. house of Hungarian Academy of Sciences, 1982. Pp. 579–620 (in Russian).

15. Aralova M.V., Glukhov A.A. Harakter operativnyh vmeshatel'stv pri holedoholitiaze i ego oslozhneniyah [The treatment of choledocholithiasisand of its complications]. Vestnik novyh medicinskih tehnologii – Journal of New Med-ical Technologies, 2010, vol. 17, no. 2, pp. 101–102 (in Rus-sian).

16. Merzlikin N.V., Brazhnikova N.A., Alperovich B.I., Tskhai V.F. Klinicheskie lekcii po abdominal'noy khirurgii: uchebnoe posobie [Clinical lectures on abdominal surgery]. Tomsk, TML-Press Publ., 2007 (in Russian).

17. Al'perovich B.I. Hirurgiya pecheni [Surgery of the liver]. Moscow, GEOTR-Media Publ., 2010. 348 p. (in Russian).

18. Shapoval'yanc S.G., Ardasenov T.B., Fedorov E.D. et al. Hirurgicheskaya taktika lecheniya holedoholitiaza, oslozhnennogo mehanicheskoy zheltuhoy, u bol'nyh s izmenennoy anatomiey bilioduodenal'noy oblasti [The surgi-cal tactics of treatment of the choledocholithiasis, complicat-ed by the obstructive jaundice, in patients with the altered bilioduodenal anatomy]. Khirurgiia. Zhurnal imeni N.I. Pirogova, 2011, no. 10, pp. 35–38 (in Russian).

19. Korolyov M.P., Fedotov L.Ye. et al. Holedoholitiaz v nestandaotnyh situacijah: vozmozhnosti kombinirovannyh metodov maloinvazivnogo vmeshatel'stva [Choledocholithiasis in nonstandard situations: the possibil-ity of combined methods for minimally invasive interven-tions]. Vestnik khirurgii im. I.I. Grekova, 2012, no. 4, pp. 74–78 (in Russian).

20. Shapovaliants S.G., Mylnikov A.G., Pankov A.G. et al. Recidivnyj holedoholitiaz: diagnostika, profilaktika i lechenie [Recurrent choledocholithiasis: diagnosis, preven-tion and treatment]. Eksperimentalnaya i klinicheskaya gastrojenterologiya – Experimental & Clinical Gastroenter-ology, 2012 (in Russian).

21. Kotovsky A.Ye., Glebov K.G., Urzhumtseva G.A., Petrova N.A. Endoskopicheskie tehnologii v lechenii zabolevaniy organov gepatopankreatoduodenal'noy zony [Endoscopiic technollogiies in hepatopancreatobiliary zone diseases]. Annaly khirurgicheskoy gepatologii – Annals of Surgical Hepatology, 2010, vol. 15, no. 1, pp. 9–18 (in Rus-sian).

22. Gabriel S.A., Dyn'ko V.Yu., Gol'fand V.V. et al. Endosopicheskie chrespapillyarnye vmeshatel'stva v diagnostike i lechenii holedoholitiaza [Endoscopic crespellano intervention in the diagnosis and treatment of choledocholithiasis]. Medical Sciences. Fundamental Re-search, 2012, no. 2, pp. 276–282.

23. Burdyukov M.S., Nechipai A.M., Yurichev I.N. Otsenka tyazhesti sostoyaniya bol'nyh, obuslovlennoj mekhanicheskoj zheltukhoj opukholevoj prirody, v prognoze razvitiya oslozhnenij ERHPG i endoskopicheskoj retrogradnoj biliarnoj dekompressii [Assessment of severity of obstructive jaundice of tumoral for predicting of endo-scopic retrograde holetsistopankreatografical complications and biliary decompression]. Eksperimental'naya i klinicheskaya gastroenterologiya – Experimental & Clinical Gastroenterology, 2010, no. 4, pp. 78–84 (in Russian).

24. Kolokoltsev V.B. Endoskopicheskaya retrogradnaya holangiopankreatografiya. Endoskopicheskaya hirurgiya BDS i obshhego zhelchnogo protoka [Endoscopic retrograde cholangiopancreatography. Endoscopic surgery of LDP and common bile duct]. Voprosy organizatsii meditsinskoj pomoschi v usloviyakh krupnogo meditsinskogo tsentra – Is-sues of organization of medical aid in the conditions of a large medical center, 1994, pp. 165–167 (in Russian).

25. Kushnerenko O.Yu. Znachenie ERHPG v diagnostike zabolevaniy zhelchevyvodyaschih putey i podzheludochnoy zhelezy [The value of ERCP in the diagnosis of diseases of the biliary tract and pancreas]. Problemy mediciny i biologii – Problems of medicine and biology, Kemerovo, 1996, pp. 54–55 (in Russian).

26. Vasiliyev Yu.V., Zelenikin S.A., Stavinsky A.A. Diagnosticheskaya endoskopiya u bol'nykh s holedokhoduodenal'nym anastomozom [Diagnostic endos-copy in patients with choledochoduodenostomy anastomo-sis]. Klinicheskaya khirurgiya – Clinical Hospital Surgery, 1984, no. 10, pp. 80–82 (in Russian).

27. Arregni M.E., Davis C.J. et al. Laparoscopic cholecystecto-my cambinet with endoscopic sphincterotomy and stone ex-traction or laparoscopic litotripsy for management of cholelithiasis. Surg. Endosc., 1992, vol. 6, pp. 10–15.

28. Adamonis K. Neudachi, oshibki i oslozhneniya endoskopicheskoy retrogradnoy kholangiopankreatografii. Dis. kand. med. nauk [Failures, errors, and complications of endoscopic retrograde cholangiopancreatography. Dis. Cand. med. Sci.]. 1992 (in Russian).

29. Winslet M.C., Neoptolemos J.P. The place of endoscopi in the management of gallstones. Baillieres Clin. Gastroenterol., 1991, vol. 5, no. l, pp. 99–29.1

30. Wilson M., Tweedle D., Martin D. Comon bile diameter and complications of endoscopic sphincterotomy. Br. J. Surg., 1992, vol. 79, pp. 1346–1347.

31. Bairamov N.Yu., Zeinalov N.A., Pashazade V.A. Laparo-skopicheskaya kholedokhoduodenoskopiya [Laparoscopic choledochoduodenostomy]. Khirurgiia. Zhurnal im. N.I. Pirogova, 2013, no. 1, pp. 43–46 (in Russian).

32. Smolin V.G. Endoskopicheskaya suprapapillyarnaya kholedokhoduodenostomiya v lechenii kholedokholitiaza terminal'nogo otdela obschego zhelchnogo protoka. Dis. kand. med. nauk [Endoscopic suprapapillary choledochoduodenostomy in the treatment of choledocholithiasis terminal segment of the common bile duct: Dis. Cand. med. sci.]. Khabarovsk, 2004 (in Russian).

33. Khryachkov V.V., Levchenko N.V., Belousov V.V. Pritsel'naya kontaktnaya lazernaya litotripsiya – novye vozmozhnosti v lechenii zhelchekamennoj bolezni [Sighting contact laser lithotripsy – new possibilities in the treatment of cholelithiasis]. Uspehi sovremennogo estestvoznaniya – Advances in Current Natural Sciences, 2008, no. 5, pp. 152–154 (in Russian).

34. Hochberger J., Tex S., Miass J. et al. Management of com-mon bile duct stones. Gastrointest. Endosc. Clin. Am., 2003. vol. 13, pp. 623–634.

35. Sandler R.S., Everhart J.E., Donowitz M. et al. The burden of selected digestive diseases in the United States. Gastroen-terology, 2002, May, vol. 122 (5), pp. 1500–1511.

36. Binmoeller K.F., Bruckner M., Thonke F. et al. Treatment of difficult bile duct stones using mechanical, electrohydraulic and extracorporeal shock wave lithotripsy. Endoscopy, 1993, vol. 25, pp. 201–206.

37. Blind P.J., Lundmark M. Management of bile duct stones: lithotripsy by laser, electrohydraulic, and ultrasonic tech-niques. Eur. J. Surg., 1998, vol. 164, pp. 403–409.

38. Petrova D.D. Krovotechenie kak oslozhnenie JeRHPG [Bleeding as a complication of ERCP]. Studencheskaya nauka i meditsina XXI veka: traditsii, innovatsii i prioritety: sbornik materialov VIII Vserossijskoj (82-j Itogovoj) studencheskoy nauchnoy konferentsii, posvyashhennoy 95-letiyu SamGMU [Student science and medicine of the XXI century: traditions, innovations and priorities: Materials of VIII all-Russia. (82 Total) Stud. scientific. Conf. devoting to 95th anniversary of the Samara State Medical University]. Samara, 2014. Pp. 177–178 (in Russian).

39. Tarasenko S.V., Bryantsev Ye.M. Marakhovtsev S.L., Kopeikin A.A. Oslozhneniya endoskopicheskikh transpapillyarnyh vmeshatel'stv u bol'nykh dobrokachestvennymi zabolevaniyami zhelchnykh protokov [Compllications of endoscopic transpapillary interrventions in bille duct benign disease patients]. Annaly khirurgicheskoi gepatologii – Annals of Surgical Hepatology, 2010, vol. 15, no. 1, pp. 21–26 (in Russian).

40. Freeman L. Adverse outcomes of endoscopic retrograde cholangiopancreatography. Rev. Gastroenterol. Dis., 2002, vol. 2, pp. 147–168.

41. Jakobs R., Maier M., Kohler B. et al. Peroral laser lithotripsy of difficult intrahepatic and extrahepatic bile duct stones: la-ser effectiveness using an automatic stone-tissue discrimina-tion system. Am. J. Gastroenterol., 1996, vol. 91, pp. 468–473.

42. Moon J.H., Cha S.W., Ryu C.B. et al. Endoscopic treatment of retained bile-duct stones by using a balloon catheter for electrohydraulic lithotripsy without cholangioscopy. Gastrointest. Endosc., 2004, vol. 60, pp. 562–566.

43. Wolfsen H., Hemminger L., Achem S. et al. Complications of endoscopy of the upper gastrointestinal tract: a single-center experience. Mayo Clin. Proc., 2004, vol. 79, pp. 1264–1267.

44. Chernenko V. et al. Method for intracorporeal lithotripsy fragmentation and apparatus for its implementation: patent US 7,087,061/B2/ – Semptember 18, 2003.

45. Das A.K., Chiura A., Conlin M.J. et al. Treatment of biliary calculi usin holmium: yttrium aluminum garnet laser. Gastrointest. Endosc., 1998, vol. 48, pp. 207–209.

46. Freeman L., Nelson D., Sherman S. et al. Complications of endoscopic biliary sphincterotomy. New. Engl. J. Med., 1996, vol. pp. 909–918.

47. Gudkov A.V., Boschenko V.S., Chernenko V.P., Ivano-va L.Yu. Metodika retrogradnoy kontaktnoy nanoelektroimpul'snoy litotripsii [Method of retrograde contact nanopulse lithotripsy]. Vestnik novyh medicinskih tehnologii – Journal of New Medical Technologies, 2013, vol. 20, no. 2, pp. 427–433 (in Russian).

48. Gudkov A.V., Boschenko V.S. Effektivnost' retrogradnoy kontaktnoy elektroimpul'snoy litotripsii [The efficacy of ret-rograde contact nanopulse lithotripsy]. Medicinskiy vestnik Bashkortostana, 2011, vol. 6, no. 2, pp. 242–244 (in Rus-sian).

49. Okhotnikov O.I., Grigoriyev S.N., Yakovleva M.V. Opyt 100 uspeshnykh antegradnykh transpechenochnykh kontaktnykh holedoholitotripsij v lechenii endoskopicheski trudnogo kholedokholitiaza [Experience of 100 successful antegrade transhepaticcontact choledocholithothripsy as treatment in patientswith difficulties of endoscopy method]. Diagnosticheskaya i interventsionnaya radiologiya – Diag-nostic and Interventional Radiology, 2011, vol. 5, no. 1, pp. 67–72 (in Russian).

50. Ilchenko A.A. Bolezni zhelchnogo puzyrya i zhelchnyh putey. Rukovodstvo dlya vrachey [Diseases of the gallbladder and biliary tract]. Moscow, MIA Publ., 2011 (in Russian).


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For citations:


Merzlikin N.V., Podgornov V.F., Semichev Ye.V., Bushlanov P.S., Talacheva V.D. THE METHODS OF CHOLEDOCHOLITHIASIS TREATMENT. Bulletin of Siberian Medicine. 2015;14(4):99-109. (In Russ.) https://doi.org/10.20538/1682-0363-2015-4-99-109

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