The surgical tactics in case of bile flow after miniinvasive cholecystoectomy
The paper analyzes the results of surgical treatment of 4511 patients operated on for calculous cholecystitis in various ways. Frequency bile leakage after mini-access (n = 2452) was 0,65% after laparoscopic cholecystectomy (n = 1267) - 0,95%, after the traditional laparotomic cholecystectomy (n = 792) -1,13% (p <0,05). Developed surgical approach is based on data ultrasound and endoscopic retrograde cholangiopancreatography, independent of the type performed cholecystectomy and can improve treatment outcomes and to avoid septic complications and deaths. Endoscopic treatment (papillosfinkterotomiya, nazobiliarnoe drainage, bilioduodenalnoe stenting) are effective in 50% of patients.