Features of the treatment tactics for patients with obstructive jaundice

   Objective. Treatment of obstructive jaundice still remains one of the most pressing problems in emergency surgery. Due to the complicated course of the pathological process of the organs of the hepatopancreatobiliary zone against the background of the development of obstructive jaundice, the first stage of treatment is necessary to perform temporary decompression of the bile ducts, before radical surgery, in order to relieve biliary hypertension, assess the functional reserve of the liver and predict the timing of the main stage of surgical treatment, as well as the expected course of the postoperative period. The article contains data on the staged treatment of patients with obstructive jaundice syndrome, when the main surgical intervention is performed after relieving biliary hypertension. This treatment method can reduce the number of postoperative complications and mortality.

   The main task in this case is the prevention of liver failure with the development of hypocoagulation, which is the main condition for radical surgical intervention.

   Material and methods. At the Tomsk Hepatology Center, 152 high-tech minimally invasive procedures were performed on patients with obstructive jaundice of various etiologies, which significantly improved treatment results and shortened the patient’s length of stay in the hospital.

   Results. Based on modern methods for diagnosing obstructive jaundice, an algorithm for examining and treating patients is shown, depending on the technical capabilities of the hospital. The stages of diagnostic and therapeutic procedures are shown, which may differ due to the level of bile duct occlusion, as well as its etiology. In addition, a definition of a hospital of the first, second and third levels is given and patient routing is determined.

   Conclusion. Treatment of obstructive jaundice of any origin should be carried out in two stages. The first stage includes diagnostic and therapeutic measures aimed at reducing the threat of developing organ failure. The second stage is to carry out radical treatment. The level of care is determined by the diagnostic and personnel potential of a particular medical institution.

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