8 -7 (69) 2024 - Boltayev N.R., Urokov Sh.T. - APPLICATION OF NASOBILIARY DRAINAGE IN TREATMENT OF LONG-TERM OBSTRUCTIONAL JAUNDICE OF BENIGN GENESIS

APPLICATION OF NASOBILIARY DRAINAGE IN TREATMENT OF LONG-TERM OBSTRUCTIONAL JAUNDICE OF BENIGN GENESIS

Boltayev N.R. - Bukhara State Medical Institute named after Abu Ali ibn Sina, Bukhara branch of the Republican Scientific Center for Emergency Medical Care Uzbekistan

Urokov Sh.T. - Bukhara State Medical Institute named after Abu Ali ibn Sina, Bukhara branch of the Republican Scientific Center for Emergency Medical Care Uzbekistan

Abidov U.O. - Bukhara State Medical Institute named after Abu Ali ibn Sina, Bukhara branch of the Republican Scientific Center for Emergency Medical Care Uzbekistan

Resume

The results of treatment of 112 patients suffering from long-term mechanical jaundice of benign etiology were analyzed. For the control group of patients, 46 case histories were selected and analyzed retrospectively. The main group of patients consisted of 66 patients with long-term mechanical jaundice of benign etiology. In the control group there were 31 (67.4%) women and 15 (32.6%) men. In the main group there were 28 (42.4%) men and 33 (57.6%) women. On admission, most patients had severe disease severity. The duration of jaundice was more than 14 days. The cause of the obstruction of the patency of the bile ducts was various factors, mainly large stones and their combinations, the breakthrough of an echinococcal cyst into the bile ducts of the stricture. For diagnosis, various methods were used, such as clinical and laboratory examination, ultrasound, ERCP, EPST, MRCP and others. The treatment program in the control group included endoscopic decompression with and without stenting, simultaneous surgical interventions and standard infusion and antibacterial therapy. The main group of patients underwent endoscopic decompression with stenting, nasobiliary drainage (NBD) and early plasmapheresis (ePP) in combination in small subgroups in order to determine their effective combination. All patients of the main group, along with standard therapy, received glutathione and remaxol from the 1st day. As a result of treatment, in patients of the main group, compared with the control group, the rates of complications in the post-decompression period and mortality from liver failure and reperfusion syndrome sharply decreased. This made it possible to carry out radical surgical operations with minimal risk to patients.

Key words: prolonged mechanical jaundice, nasobiliary drainage.

First page

47

Last page

53

For citation:Boltayev N.R., Urokov Sh.T., Abidov U.O. - APPLICATION OF NASOBILIARY DRAINAGE IN TREATMENT OF LONG-TERM OBSTRUCTIONAL JAUNDICE OF BENIGN GENESIS//New Day in Medicine 7(69)2024 47-53 https://newdayworldmedicine.com/en/new_day_medicine/7-69-2024

List of References

1. Wang L., Yu W.F. Obstructive jaundice and perioperative management. //Acta Anaesthesiol. Taiwan. 2014;52(1):22–29.
2. Абакумов М.М., Мусселиус С.Т., Александровский В.Н. Диагностика и лечение острой печеночной недостаточности. - НИИ ск. помощи им. Н.В.Склифосовского,1998; с.47.
3. Гальперин Э.И. Механическая желтуха: состояние «мнимой стабильности», последствия «второго удара», принципы лечения / Э.И. Гальперин //Анналы хирургической гепатологий. 2011;3:16.
4. Гальперин Э.И. Оптимальный уровень общего билирубина перед выполнением окончательного этапа лечения при механической желтухе опухолевой этиологии /Э.И. Гальперин, А.Е. Котовский, О.Н. Момунова И //Анналы хирургической гепатологии. 2011;16(1):45-51.
5. Гальперин Э.И., Момунова О.Н. Классификация тяжести механической желтухи. //Хирургия. Журнал им. Н.И. Пирогова. 2014;1:5-9.
6. Гальперин Э.И. Механическая желтуха: состояние “мнимой стабильности”, последствия “второго удара”, принципы лечения. //Анналы хирургической гепатологии. 2011;16(3):16-25.
7. Шевченко Ю.Л., Ветшев П.С., Стойко Ю.М., Левчук А.Л., Конторщикова Е.С. Приоритетные направления в лечении больных с механической желтухой. //Анналы хирургической гепатологии. 2011;16(3):9-15.

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