Experience of using minimally invasive transpapillary surgical interventions in urgent abdominal surgery

Objectives. To determine the features of the practical use of minimally invasive transpapillary interventions in urgent abdominal surgery. Materials and methods. The results of endoscopic treatment of patients with choledocholithiasis and icteric tumors of the periampullary zone were studied of 2305 patients with stones in the common bile ducts and periampullary tumors over a 6-year period were studied. 1690 transpapillary interventions were performed in patients with choledocholithiasis and 615 endoscopic operations in patients with periampullary malignant neoplasms. Results. Complications of endoscopic operations in patients with choledocholithiasis occurred in 7.5% of patients, in patients with periampullary malignant neoplasms - in 11.7% of cases. Endoscopic transpapillary interventions were urgently performed to treat purulent cholangitis and obstructive jaundice. Conclusion. Endoscopic transpapillary interventions for benign and malignant obstruction of the biliary tract should be performed in clinics equipped with modern X-ray endoscopic equipment and qualified specialists.

abdominal surgery, purulent cholangitis, complications, laparoscopic surgery, choledocholithiasis, endoscopic treatment

1. Romashchenko P.N., Fekliunin A.A., Maistrenko N.A., Filin A.A., Omran V.S., Zherebtsov E.S. Trans-papillary endoscopic surgery: predictors of complications and prevention of their development. Endoscopic Surgery. 2021;27(1):40-48. (In Russ.)@@ Ромащенко П.Н., Феклюнин А.А., Майстренко Н.А., Филин А.А., Омран В.С., Жеребцов Е.С. Транспапиллярные эндоскопические операции: предикторы осложнений и профилактика их развития. Эндоскопическая хирургия. 2021;27(1):40-48.

2. Melloul E., Lassen K., Roulin D. et al. Guidelines for Perioperative Care for Pancreatoduodenectomy: Enhanced Recovery After Surgery (ERAS) Recommendations 2019. World J Surg. 2020;44(7):2056-2084. doi: 10.1007/s00268-020-05462-w.

3. Solodkiy V.A., Kriger A.G., Gorin D.S. et al. Pancreaticoduodenectomy - results and prospects (two-center study). Khirurgiya. Zurnal im. N.I. Pirogova. 2023;(5):13-21. (In Russ.) doi: 10.17116/hirurgia202305113.@@ Солодкий В.А., Кригер А.Г., Горин Д.С. и др. Панкреатодуоденальная резекция - результаты и перспективы (двухцентровое исследование). Хирургия. Журнал им. Н.И. Пирогова. 2023;(5):13-21. doi: 10.17116/hirurgia202305113.

4. Kriger A.G., Pronin N.A., Dvukhzhilov M.V., Gorin D.S., Pavlov A.V., Karmazonovsky G.G. Surgical glance at pancreatic arterial anatomy. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2021;26(3):112-122. (In Russ.) doi: 10.16931/1995-5464.2021-3-112-122.@@ Кригер А.Г., Пронин Н.А., Двухжилов М.В., Горин Д.С., Павлов А.В., Кармазановский Г.Г. Хирургический взгляд на артериальную анатомию поджелудочной железы. Анналы хирургической гепатологии. 2021;26(3):112-122. doi: 10.16931/1995-5464.2021-3-112-122.

5. Kovalenko Z.A., Efanov M.G. Scoring systems to predict pancreatic fistula after Whipple procedure. Pirogov Russian Journal of Surgery = Khirurgiya. Zurnal im. N.I. Pirogova. 2021;(7):71-76. (In Russ.) doi: 10.17116/hirurgia202007161.@@ Коваленко З.А., Ефанов М.Г. Шкалы прогноза панкреатической фистулы после операции Уиппла. Хирургия. Журнал им. Н.И. Пирогова. 2021;07:71-76. doi: 10.17116/hirurgia202007161.

6. Schuh F., Mihaljevic A.L., Probst P. et al. A Simple Classification Of Pancreatic Duct Size and Texture Predicts Postoperative Pancreatic Fistula: A classification of the International Study Group of Pancreatic Surgery (ISGPS) [published online ahead of print, 2021 Mar 12]. Ann Surg. 2021. doi: 10.1097/SLA.0000000000004855.

7. Russell T.B., Aroori S. Procedure-specific morbidity of pancreatoduodenectomy: a systematic review of incidence and risk factors. ANZ J Surg. 2022;92(6):1347-1355. doi: 10.1111/ans.17473.

8. Bootsma B.T., Plat V.D., van de Brug T. et al. Somatostatin analogues for the prevention of pancreatic fistula after open pancreatoduodenectomy: A nationwide analysis. Pancreatology. 2022;22(3):421-426. doi: 10.1016/j.pan.2022.03.006.