DIAGNOSIS AND TREATMENT OF THE CHOLEDOCHODUODENAL FISTULAS
Abstract
Aim. To improve the diagnosis and surgical treatment of choledochoduodenal fistulas due to ulcer and cholelithiasis.
Material and methods. The results of complex diagnostics and surgical treatment of 54 patients with choledochoduodenal fistulas were analyzed. Choledochoduodenal fistulas due to cholelithiasis occurred in 35 (64.8%) patients, and in 19 (35.2%) cases the cause was the peptic ulcer. In the clinical manifestations of the choledochoduodenal fistulas, three types of the disease course were distinguished. The first type (n = 17) was asymptomatic, the second type (n = 16) had a clinical picture of duodenal ulcer and the third type (n = 21) had a predominance of clinical characteristics of cholangitis and choledocholithiasis.
Results. Ultrasound examination in 24 (44.4%) cases revealed a dilatation of the common bile duct and the presence of the aerobilia in 14 cases. In 8 cases, endoscopy revealed the appearance of bile from the crater of an ulcer. Radiologic examination in 27 (50%) of observations revealed a contrast agent entering the bile ducts, and the aerobolia in 14 cases.
Сonclusion. The non-standard surgical situations in the treatment of the choledochoduodenal fistulas require a strictly differentiated approach in each specific case.
About the Authors
K. R. Nazirboev
Department of general surgery №1 Tajik State Medical University named after Abuali Ibni Sino, State Institution “Istiklol Health Complex”
Tajikistan
Tajikistan
Nazirboev Kahramon Ruziboevich - Candidate of Medical Science, Assistant
tel .: +992 93 405 44 04
K. M. Kurbonov
Department of general surgery №1 Tajik State Medical University named after Abuali Ibni Sino, State Institution “Istiklol Health Complex”
Tajikistan
Tajikistan
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Review
For citations:
Nazirboev K.R., Kurbonov K.M. DIAGNOSIS AND TREATMENT OF THE CHOLEDOCHODUODENAL FISTULAS. Health care of Tajikistan. 2018;(1):58-62. (In Russ.)
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