Bile duct stones

Bile duct stones are one of the manifestations of cholelithiasis. After an attack of hepatic colic, itching can occur, icteric sclera, visible mucous membranes of the skin, discolored feces, urine of dark color. The prolonged existence of mechanical jaundice leads to the development of biliary cirrhosis, hepatic coma, and cholemic hemorrhage. The addition of cholangitis significantly worsens the general condition of the patient: high fever, chills, profuse sweat, liver failure increases rapidly. With a satisfactory state of the patient, short-term jaundice after short-term treatment (broad-spectrum antibiotics, antispasmodics, infusion detoxification therapy, vitamin therapy, especially vitamin K), operative intervention-cholecystectomy, choledochotomy, extraction of stones from choledochus and drainage thereof. With a high risk of surgical intervention (advanced age, severe concomitant diseases, extreme bilirubin numbers, prolonged jaundice), it is preferable to use endoscopic papillotomy, restoring the outflow of bile to the duodenum.

Surgical papillotomy should be performed only if the endoscopic method can not be used or its ineffectiveness, since severe complications in the first case occur 2-3 times more often than with endoscopic dissection of the large papilla of the duodenum. With the elimination of jaundice and stifling of acute phenomena after endoscopic papillotomy, a planned sanation of the bile ducts is performed.