Problem issues in diagnostics and treatment of choledocholithiasis in the era of wide implementation of minimally invasive surgery

Abstract

Modern methods of treating choledocholithiasis (CDC) are varied and are mainly focused on minimally invasive endoscopic technologies. The variety of these methods indicates the absence of a “gold standard”, and each of them has its own advantages and disadvantages. In this regard, the search for new surgical solutions to this problem is still relevant. This study presents a retrospective analysis of the treatment of 168 patients with HDL (2019-2023), who underwent laparoscopic surgery (LO) in 26 patients (15.5%) and surgical interventions through a minilaparotomy approach (MLA) in 142 patients (84.5%), and the average age was 59.0 ± 2.6 years, the ratio of men to women was 1:2.8 (p <0.05). A diagnostic and treatment algorithm was developed for HDL in combination with cholecystolithiasis. Magnetic resonance cholangiopancreatography (MRI UCG) has been recorded to be highly sensitive in preoperative research methods - 89.2%, ultrasound (US) - 93.8%, intraoperative ultrasound (IOUS) - 99.4%. The result of the development, scientific substantiation and implementation of the presented algorithm was a reduction in the number of conversions for ALD to 2.8%, for LO - to 5.6%, and mortality - to 2.9%.