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Endoscopical diagnosis and treatment of complicated biliary obstructions with mechanical jaundice


Author: Alic Cotoneţ
Degree:doctor of medicine
Speciality: 14.00.27 - Surgery
Year:2007
Scientific adviser: Vladimir Hotineanu
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 25 April, 2007
Approved by NCAA on the 14 June, 2007

Abstract

Adobe PDF document1.03 Mb / in romanian

Thesis

CZU : 616.36-008.5-072.1-08

Adobe PDF document 5.62 Mb / in romanian
127 pages


Keywords

mechanical jaundice, ERCP, biliary obstructions, endoscopical treatment

Summary

The purpose of the study is to determine the endoschopic possibilities in diagnosis of distal billiary obstructions with jaundice using CPGRE just like the systematization of radical or palliative treatment methods for these pacients.

Starting with the 789 ERCP performed, 34% of succeeded only after the application of the prediagnostical incisions on the longitude pleat, also the indications and opposite-directives in using ERCP were specified. 158 cases were selected in order to specify mini-invasiv treatment for billiary obstructions:

  1. Choledocolithiasis – 62
  2. Oddi – coledoc stenosis – 44
  3. Distal malignant blocs – 32
  4. Control group – 20
The control group consists of pacients wich from several reasons didn’t took benefit of preoperative endoschopic management, while the fistulography detected: The mini-invasive approach analysis of pacients with distal blocs allowed the elaboration of an endoschopical curative diagnostical algorithm.

The application of this algorithm will allow the obtaining of more better results in the treatment of pacients with jaundice and lowering the specifical complications.