Endoscopic light-guided choledochoduodenostomy in the treatment of the distal common bile duct obstruction
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1
Faculty of Health Care and Social Work, Trnava University in Trnava, Slovak Republic
2
Surgical Clinic, Trnava University Hospital, Slovak Republic
3
Director, State Organization «V.T. Zaytsev Institute of General and Emergency Surgery of the National Academy of Medical Sciences of Ukraine», Kharkiv, Ukraine, Ukraine
4
Department of operative endoscopy, State Organization «V.T. Zaytsev Institute of General and Emergency Surgery of the National Academy of Medical Sciences of Ukraine», Kharkiv, Ukraine, Ukraine
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Department of Oncology, Oncosurgery, Radiation Therapy and Palliative Care, Kharkiv National Medical University of the Ministry of Health of Ukraine, Ukraine
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Anesthesiology Clinic, Trnava University Hospital, Slovak Republic
Submission date: 2023-10-11
Final revision date: 2024-03-24
Acceptance date: 2024-07-17
Publication date: 2024-09-03
Corresponding author
Valerii Vovk
Faculty of Health Care and Social Work, Trnava University in Trnava, Hornopotochna 23, 91843, Trnava, Slovak Republic
Wiadomości Lekarskie 2024;77(8):1547-1553
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ABSTRACT
Aim:
Experimental justification for creation of bile offtake into the duodenum with minimally invasive methods in cases of obstruction of the distal part of common bile duct and failure of transpapillary interventions and studying the first results of such intervention application.
Material and methods:
The anatomical relationships between the duodenum and the common bile duct in its distal parts starting from its retroduodenal part to the sphincter of Oddi were studied. The possibility of transillumination of the walls of the common bile duct and the duodenum by a light source introduced into the lumen of the common bile duct is determined.
Results:
The length of a conventional straight line between the lumens is from 7.1±0.2 mm at a distance of 50 mm from the sphincter of Oddi to 4.7±0.1 mm at a distance of 30 mm from the sphincter of Oddi. In the distance up to 40 mm from the sphincter of Oddi, the common bile duct and the duodenum are in close proximity to each other without free spaces, that predispose for the connection formation between the lumens of the duodenum and the common bile duct. The technology of endoscopic light-guided choledochoduodenostomy is substantiated, developed and implemented.
Conclusions:
Created method of endoscopic light-guided choledochoduodenostomy allows to perform a conjunction between the lumens of the duodenum and the common bile duct. This intervention can be used when endoscopic transpapillary drainage of the common bile duct is impossible and has advantages over open draining bile duct operations in patients with tumor distal common bile duct obstruction.