IMPROVEMENT OF THE RESULTS OF BILIODIGESTIVE ANASTOMOSIS IN CHILDREN WITH CHOLEDOCH CYSTS

Abstract

Treatment of cystic transformation of the common bile duct (CTJD) is surgical, the “gold standard” today is considered to be hepaticojejunoanastomosis on the disconnected loop according to Roux, however, the passage of bile after this surgical intervention causes a number of complications, in particular intestinal dysfunction. This is the main impetus for the development of new methods of surgical treatment, allowing to save the passage of bile through the 12th duodenum. Objective of the study: To improve the results of treatment of cystic transformation of the biliary tract in children. Material and methods of research: The analysis was carried out in 48 children aged 3-14 years with cystic transformation of the biliary tract, who were on inpatient treatment in the clinic of pediatric surgery of the TashPMI and the RSNPMC of Pediatrics and the State Medical Institute for the period from 2012 to 2020. Diagnostic methods included a number of generally accepted clinical and biochemical blood tests that make it possible to judge the degree of depression of liver functions. A number of special research methods were also carried out: ultrasound examination of the liver, biliary tract and spleen, multislice computed tomography, magnetic resonance imaging without contrast cholangiography, morphological examination of the hepatic parenchyma and cystic choledochus, gallbladder, indirect elastometry of the liver, blood coagulation activity was assessed . The most commonly used operation was hepaticojejunoanastomosis on a disabled Roux-en-Y loop with the creation of an antireflux mechanism. Results and conclusion. According to the study, it can be concluded that the surgical treatment of choledochal cysts should be carried out after establishing the diagnosis, while the operation of choice is the operation of hepaticojejunostomy on the disconnected loop according to Roux and hepaticojejunoduodenoanastomosis according to Raffensperger. The use of new technologies ensures the flow of bile directly into the duodenum. This promotes balanced digestion.