DOI: 10.31082/1728-452X-2019-208-209-10-11-87-93
UDC 616.36-002.12-08
МРНТИ 76.29.55
OBSTRUCTIVE JAUNDICE OF BENIGN GENESIS: A PRESENT-DAY CONCEPT OF TREATMENT (literature review)
Aliya M AITBAYEVA, https://orcid.org/0000-0001-5608-1127,
Bazylbek S ZHAKIEV, https://orcid.org/0000-0001-9828-5101
West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakstan

The article presents a review of the literature of domestic and foreign authors on the treatment of patients with obstructive jaundice syndrome in benign diseases of the hepatobiliary zone.
The aim. To study modern approaches to the treatment of obstructive Jaundice of benign genesis in the context of the development of science.
Material and methods. A literature search was carried out on research in the following databases: Scientific Electronic Library, Scopus, Medline/PubMed. Forty-one publications containing data on the treatment of obstructive jaundice of benign genesis were selected for analysis. Search depth accounts for 15 years. Inclusion criteria: sources from 2003-2018, development of treatment methods, evaluation of the effectiveness of treatment of patients with obstructive jaundice of benign genesis, the diagnosis of Obstructive Jaundice is consistent with international criteria and Clinical Protocols of the Republic of Kazakhstan. Exclusion criteria were: duplicate publications, articles on obstructive Jaundice of benign genesis, but do not reveal the treatment in this disease and, therefore, are not appropriate in subject, as well as experimental work on animals.
Results and discussion. The analysis of various types of operations on the biliary tract and liver in the syndrome of obstructive jaundice of various etiologies. The complexity of treating patients with obstructive jaundice is due to the severity of their initial condition. Developing cholestasis, biliary hypertension, and acholia cause gross functional and morphological changes in the liver, which lead to a relatively rapid development of liver failure, which causes a high mortality rate. The search for ways to reduce the number of lethality and complications of many researchers has led to the fact that today the two-stage treatment tactics with the use of minimally invasive treatment methods has become more widely used, allowing to achieve the maximum result with minimal operating trauma. The use of endoscopic papillosphincterotomy as a method of choice for obstructive jaundice with choledocholithiasis, regardless of age and the presence of comorbidities, and as the main treatment method, is accompanied by the development of a number of terrible complications, such as bleeding, acute pancreatitis, acute cholangitis, retroduodenal perforation and others, occurring in 5.4-18.3% of patients according to many authors. Perhaps this explained the lack of consensus regarding minimally invasive methods of treatment.
Conclusions. Today, the issue of the optimal complex of therapeutic measures in patients with obstructive jaundice remains incompletely resolved, which explains the need to continue to look for new ways to solve this problem.

Keywords: obstructive jaundice, cholelithiasis, choledocholithiasis, minimally invasive treatment methods.

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