GALLSTONE DISEASE AND BILIARY PANCREATITIS COMPLICATED BY MECHANICAL JAUNDICE. REVIEW

Abstract

Introduction: Combined diseases of the digestive system are established in every third patient hospitalized in surgical
hospitals. However, simultaneous operations in comorbidity are performed in 1-5% of cases, reaching in some surgical
clinics 6% of all surgical interventions performed. The combination of cholelithiasis (GSD), peptic ulcer disease, pancreatitis,
and their complications deserve special attention, in which close topographic anatomical and functional relationships lead to
interdependent damage to related organs. In recent years, there has been an increase in the incidence of diseases of the
organs of the hepatopancreatoduodenal system (GPDS).
Aim: To review the literature on gallstone disease and biliary pancreatitis complicated by mechanical jaundice.
Search strategy: Literature search was carried out in search engines: Pubmed, Google Academy, elibrary.ru, as well as
"manually". The search depth of Pubmed, Google Academy, elibrary.ru, as well as "manually", was not limited. The following
filters were applied: full text, humans. Criteria for inclusion of publications in the review: publications that are in full-text
access, in Russian and English, carrying statistically verified conclusions. Exclusion criteria: duplicate data, summaries of
reports, newspaper publications, personal communications.
Results: The syndrome of mechanical jaundice complicates the course of various diseases of the
hepatopancreatobiliary zone, the common clinical sign of which is icteric staining of the sclera and skin as a result of an
increase in the concentration of bilirubin in the blood due to impaired patency of the bile ducts. One of the main problems of
hepatopancreatobiliary surgery at the present stage is the improvement of existing and the introduction into clinical practice
of new methods for early differential diagnosis of the causes of obstruction of the bile ducts and the development of
mechanical jaundice. Diagnosis of mechanical jaundice includes two fundamental points: confirmation of the obstructive
nature of jaundice and determination of the specific cause of violation of the patency of the extrahepatic bile ducts. The
timeliness of the diagnostic search largely determines the choice of an adequate surgical tool to restore the outflow of bile
from the liver.
Conclusions: Thus, we see that over the past decade, the tactics of surgical treatment of patients with obstructive
jaundice have changed significantly, the most popular are minimally invasive methods for prosthetics of the biliary function.
Combined hybrid methods for the treatment of benign structures of the biliary system are being introduced more and more.