Corrective Surgery for Complete Destruction of the Hepaticocholedochus Wall and Obstructive Jaundice of Benign Genesis

Abstract

Nazarbek Omarov, Meyrbek Aimagambetov, Medet Auenov, Samatbek Abdrakhmanov, Tolkyn Bulegenov

The treatment of Mirizzi syndrome has attracted much attention from surgeons these days since the incidence of this syndrome is progressively increasing. An increase in the frequency of the disease can be associated with high progress in diagnosing the disease. With complete destruction of the hepaticocholedochus wall and the inability to form a biliodigestive anastomosis, in certain situations, the newly developed corrective surgery on the bile ducts, cholecystohepatic choledochoplasty, can increase the likelihood of a favorable outcome. Development and implementation of a new innovative corrective surgery with complete destruction of the wall of hepaticoholedochus with obstructive jaundice. Based on the clinical case, we trace the postsurgical period, which proceeded without complications; the drain tube from the subhepatic space was removed on the 4th day; fistulocholangiography was done on the 7th day; the diameter of the hepatocholedochus was not narrowed; the contrast freely entered the duodenum. The sutures were removed on the 9th day, the drain tube from the common bile duct was removed on the 11th day. The result is full recovery. As a result of our observations and work with clinical cases, we came to the conclusion that, although diagnostic measures have improved today, the issue of complex presurgical diagnosis of pathological changes in Mirizzi syndrome remains open. The imperfection of the diagnosis must be considered every time with surgery. The proposed option of the corrective operation of cholecystohepatic choledochoplasty with complete destruction of the hepatic choledochus wall expands the possibilities of surgical treatment of Mirizzi syndrome