Authors
Maksimenkov A.V., Maady A.S., Bruslik S.V., Levchuk A.L., Sviridova T.I., Sininkina D.V.
Pirogov National Medical and Surgical Center, Moscow
Abstract
The article presents a clinical observation of patient N., 74 years old, with a history of surgery in August 2023 for cholelithiasis. During the surgical intervention, a number of complications were noted that required repeated operations and drainage of the common bile duct. In the postoperative period, drainage migrated with a clinical picture of biliary peritonitis. Relaparotomy, choledocholithotomy, lithoextraction, and redrainage of the common bile duct according to Kehr were performed. Due to the dislocation of the Kehr drainage, a drainage was installed in the subhepatic space, through which persistent external bile leakage was maintained. The patient underwent multi-stage endoscopic surgical treatment, as a result of which the passage of bile into the duodenum was restored. The external biliary fistula closed. The patient’s quality of life improved.
Keywords: external bile discharge after cholecystectomy, combined «rendezvous» technique.
References
1. Information and analytical collection “Surgical care in the Russian Federation in 2022”. (In. Russ.)
2. Lucia IS, et al. The critical view of safety during laparoscopic cholecystectomy: Strasberg Yes or No? An Italian Multicentre study. Surg Endosc. 2021; 35(7): 3698-3708. doi: 10.1007/s00464-020-07852-6.
3. Okhotnikov OI, Lutsenko VD, Yakovleva MV, et al. X-ray surgical rendezvous interventions for choledocholithiasis in elderly patients. Annals of Surgical Hepatology. 2021; 26(3): 52-59. (In Russ.)
4. Shevchenko YuL, Karpov OE. Stent surgery. M., 2020. P.233-273. (In Russ.)
