The Comparative Analysis of the Effectiveness of Endoscopic Transpapillary Interventions (Literature Review)

This article presents a comparative analysis of the effectiveness of endoscopic transpapillary management in patients with choledocholithiasis. The minimal complications are achieved using classical endoscopic papillosphincterotomy. However, in some cases, cannulation can be extremely difficult (ste...

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Autores principales: Vyacheslav B. Rinchinov, Aleksandr N. Plekhanov
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Lenguaje:RU
Publicado: Scientific Сentre for Family Health and Human Reproduction Problems 2019
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spelling oai:doaj.org-article:e60a5f5d20ce48baa569c4a9590580f42021-11-23T06:14:42ZThe Comparative Analysis of the Effectiveness of Endoscopic Transpapillary Interventions (Literature Review)2541-94202587-959610.29413/ABS.2019-4.1.18https://doaj.org/article/e60a5f5d20ce48baa569c4a9590580f42019-04-01T00:00:00Zhttps://www.actabiomedica.ru/jour/article/view/1988https://doaj.org/toc/2541-9420https://doaj.org/toc/2587-9596This article presents a comparative analysis of the effectiveness of endoscopic transpapillary management in patients with choledocholithiasis. The minimal complications are achieved using classical endoscopic papillosphincterotomy. However, in some cases, cannulation can be extremely difficult (stenosis, tumor of the major duodenal papilla, the anatomical features of the major duodenal papilla) or even impossible (wedged stone), and the introduction of a guidewire into the pancreatic duct significantly increases the risk of developing postoperative pancreatitis. The desire to increase the success when performing endoscopic papillosphincterotomy with diagnostic purpose (to perform endoscopic retrograde cholangiopancreatography after failure of traditional cannulation) and for the purpose of performing transpapillary operations has naturally led to the development of new non-standard methods of endoscopic papillotomy, the introduction of new instruments – wire guides and guided cannulas. Further increase in the frequency of successful endoscopic papillotomy can be facilitated by using atypical methods of surgery. Some authors show that classical papillosphincterotomy is comparable to the method of endoscopic papillosphincterotomy with balloon dilatation in effectiveness of extracting stones from the common bile duct. However, balloon dilatation in the extraction of choledocholithiasis is preferable due to fewer postoperative complications.The authors of this article note that endoscopic management do not always solve the problem of choledocholithiasis, but still have undeniable advantages compared with the laparotomy, in which choledocholithotomy sometimes has to be expanded, and duodenotomy with transduodenal papillosphincterotomy is conducted. Literature shows that main mortality causes after endoscopic interventions in patients with choledocholithiasis were progression of purulent cholangitis, biliary sepsis, acute postoperative pancreatitis, “discharge” syndrome.Vyacheslav B. RinchinovAleksandr N. PlekhanovScientific Сentre for Family Health and Human Reproduction Problemsarticlecholedocholithiasislarge papilla of the duodenumendoscopic papillosphincterotomyScienceQRUActa Biomedica Scientifica, Vol 4, Iss 1, Pp 120-123 (2019)
institution DOAJ
collection DOAJ
language RU
topic choledocholithiasis
large papilla of the duodenum
endoscopic papillosphincterotomy
Science
Q
spellingShingle choledocholithiasis
large papilla of the duodenum
endoscopic papillosphincterotomy
Science
Q
Vyacheslav B. Rinchinov
Aleksandr N. Plekhanov
The Comparative Analysis of the Effectiveness of Endoscopic Transpapillary Interventions (Literature Review)
description This article presents a comparative analysis of the effectiveness of endoscopic transpapillary management in patients with choledocholithiasis. The minimal complications are achieved using classical endoscopic papillosphincterotomy. However, in some cases, cannulation can be extremely difficult (stenosis, tumor of the major duodenal papilla, the anatomical features of the major duodenal papilla) or even impossible (wedged stone), and the introduction of a guidewire into the pancreatic duct significantly increases the risk of developing postoperative pancreatitis. The desire to increase the success when performing endoscopic papillosphincterotomy with diagnostic purpose (to perform endoscopic retrograde cholangiopancreatography after failure of traditional cannulation) and for the purpose of performing transpapillary operations has naturally led to the development of new non-standard methods of endoscopic papillotomy, the introduction of new instruments – wire guides and guided cannulas. Further increase in the frequency of successful endoscopic papillotomy can be facilitated by using atypical methods of surgery. Some authors show that classical papillosphincterotomy is comparable to the method of endoscopic papillosphincterotomy with balloon dilatation in effectiveness of extracting stones from the common bile duct. However, balloon dilatation in the extraction of choledocholithiasis is preferable due to fewer postoperative complications.The authors of this article note that endoscopic management do not always solve the problem of choledocholithiasis, but still have undeniable advantages compared with the laparotomy, in which choledocholithotomy sometimes has to be expanded, and duodenotomy with transduodenal papillosphincterotomy is conducted. Literature shows that main mortality causes after endoscopic interventions in patients with choledocholithiasis were progression of purulent cholangitis, biliary sepsis, acute postoperative pancreatitis, “discharge” syndrome.
format article
author Vyacheslav B. Rinchinov
Aleksandr N. Plekhanov
author_facet Vyacheslav B. Rinchinov
Aleksandr N. Plekhanov
author_sort Vyacheslav B. Rinchinov
title The Comparative Analysis of the Effectiveness of Endoscopic Transpapillary Interventions (Literature Review)
title_short The Comparative Analysis of the Effectiveness of Endoscopic Transpapillary Interventions (Literature Review)
title_full The Comparative Analysis of the Effectiveness of Endoscopic Transpapillary Interventions (Literature Review)
title_fullStr The Comparative Analysis of the Effectiveness of Endoscopic Transpapillary Interventions (Literature Review)
title_full_unstemmed The Comparative Analysis of the Effectiveness of Endoscopic Transpapillary Interventions (Literature Review)
title_sort comparative analysis of the effectiveness of endoscopic transpapillary interventions (literature review)
publisher Scientific Сentre for Family Health and Human Reproduction Problems
publishDate 2019
url https://doaj.org/article/e60a5f5d20ce48baa569c4a9590580f4
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