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11. Hwang, T.L. Contrast-enhanced dynamic computed Kashtan, O. Kaplan // Journal of Laboratory and Clinical tomography does not aggravate the clinical severity of patients Medicine. 2000. Vol. 135. 2. . 112-121.

with severe acute pancreatitis Reevaluation of the effect of 15. The various imaging aspects of chronic pancreatitis / R.

intravenous contrast medium on the severity of acute pancreatitis Graziani, M. Tapparelli, R. Malag et al. // J. Pancreas. 2005.

/ T.L. Hwang, K.Y. Chang, Y.P. Ho // Arch. Surg. 2000. Vol. 6. 1. . 73-88.

喞 616.366-003.7-02-06:616.367-003-07-089-72.,.

.. 辮纒鈔鈞 埣 III 纃鴃琺逶 碆纃逶 謌辷繿 蓍 鉐闊鰰譛 蓐. . . 第辣碌 , 諤硴 蒡 匁辷髓辮髓矗 釶鉋鉈 來, 關銓繿骼, 粮 鴈 跂粫蓁 蔘 轢 ; .. 廷 鈞 池 嚥邇碌 釶諤髓轢 謌辷繿 瘤譛辷, 碚瑾-蒡 銜粤諷辷 釶繪 蒡 蓙; .. 退迸蓁 池 嚥邇碌 釶諤髓轢 謌辷繿 瘤譛辷, 艢矼 蓍 銜粤諷辷繻 釶繪 蒡 蓙, 琿粫籥 跂粫蓁 蔘 轢 ; .. 註 鉋繧 池 嚥邇碌 釶諤髓轢 謌辷繿 瘤譛辷, 碚瑾-蒡 銜粤諷辷 釶繪 蒡 蓙. E mail: GKU@BK.RU 髓瑩 關繖髓珥諷 琿琺蒟 諷纃 67 瘤譛逶 聽譌邇 瑕纃邇 瘤諷芻, 鉐謗肭纃邇 鉉繖銛鉉蓿葯芬 髓纃鈑鉤 粫髓琺邇 銜粤諤 釶 聽譌邇 關銜 , 閻韆鈔 2002 闔 2007. 鴈 闖 瘤譛逶 關蓐纃鞫 鉐邇硴鉤 鈔邇鰰闕 跂鴈 諷纃 碼闔謐纃蒹 諤閠韲 鈿蔟繿 蔘 鈿辮瑶蓍. 鞳 譛鰰鱚 蔡驪繖鈞琿 癪諤 髓琿鈞諷轢 碼骼 鱶硴鉐鴾 諤閠韲 鈿蔟繿 蔘 鱚邇謗 蓍.

暮繧 驪鈞: 悶琿蔟繿 聽謦 , 鉉繖銛鉉蓿葯, 髓纃鈑 粫髓琺邇 銜粤諤 鉉繖銛, 辟銛蒡 蔟繿 蒹 鈿辮瑶蓙.

ENDOSURGICAL TREATMENT OF GALLSTONE DISEASE COMPLICATED BY CHOLEDOCHOLITHIASIS AND DISTAL STRUCTURE OF COMMON BILE DUCT S.N. Perekhodov Ministry of Defense of the RF, Military Clinical Hospital, Professor, Doctor of Medical Science;

O.A. Dolgov Uljanovsk Clinical Hospital, Department of General Surgery; P.N. Vanjushin Uljanovsk Clinical Hospital, Head of Department of General Surgery, Candidate of Medical Science; K.Yu. Grigorjev Uljanovsk Clinical Hospital, Department of General Surgery. E mail: GKU@BK.RU The analysis of treatment of 67 patients with gallstone disease complicated by choledocholithiasis and distal section stenosis of the common bile duct during the period from 2002 till 2007 is presented in the article. This group of patients took part in a research study of the singlestage method of treatment with laparoscopy has been preferably performed in this group of patients. The laparoscopy treatment techniques have been proved to be highly effective.

Key words: obstructive jaundice, choledocholithiasis, biliary duct stenosis, distal section stenosis of the common bile duct, endosugical treatment.

薙譌邇 瑕纃轢 瘤諷芻 硅纈 鞐髀韲髓鞐辣- 閠 鞳瑩蓿 閠 鞳鉈 韲艢 關 赭辷 轢 逶 艢瘤諷矗辷繻 碌鴃纓璢鴆 10-15% 轢驟諷- 鉈 閠 鞳瑩蓿, 辣粮髓瑩 碼骼 矗謌蔬蒡鉈 [4,5,6]. 凰踵跏 瑜鴿跏 鉐謗肭纃跏 聽譌邇- 矗迯 辟鉐 鈿蔡鴈 釶鉋 粮矗辷.

帙譛 蔡驪繖鈞琿: 鉚纃蓿 碆芟鈕邇髓 諤閠 瑕纃邇 瘤諷芻 硅鴆 鉉繖銛鉉蓿葯, 銜鉋 碌鴃纓璢鴆 8,1-26,8% 瘤譛逶, 髓纃鈑 粫髓琺- 韲 鈿蔟繿 蔘 鈿辮瑶蓍 鱚 驪 , 籥 辟鉐邇 銜粤諤 釶 聽譌邇 關銜 , 銜鉋 碌鴃- 鈿蔟繿 蒹 赭辷 蓙 辣 粮髓 闕, 蔡闔譛 璢鴆 3-40% 瘤譛逶 鉉繖銛鉉蓿葯芬 [2,3]. 鉐邇硴鉤 鈔邇鰰闕 跂鴈 諷纃 鉐謗肭纃逶 倥艾 琺逶 鉉繖銛鉉蓿葯 碌鴃纓璢鴆 2-10% 鉋 聽譌邇 瑕纃邇 瘤諷芻.

尤鱚韆琺 跂鴈糴 蔡驪繖鈞琿. 2002.

轢瘠粤辷 [1]. 汳 鉐謗肭纃 鉐鰰鴆 鉐邇硴鉗 關釶諷跪 諷纃蓙 瘤譛逶 聽譌邇 瑕纃邇 瘤- 銜粤諷辷 釶繪 蒡 蓙 嚥邇碌 鉗 釶諤髓諷芻. 瀧繖鞳辷 邇碼 粫 邇髓蔟繿 蔘 蒡 - 邇 謌辷繿 鉗 瘤譛辷 蔡闔譛 鴆 辟銛蒡 蔟繿 蒹 髀鉐釶 諷纃 聽譌邇 瑕纃邇 瘤諷 蔟繿 蔘 鱚邇謗 蓍 辣 鞳蓚 關釶諷 [7,8]. 轢髓繞 碚繻 芬謗鴿 髓琿籥頏鉤 諷纃 籥- 辷, 鉐謗肭纃邇 鉉繖銛鉉蓿葯芬 髓纃鈑鉤 粫骰鉗 閠鴈謗 蓙 硅纈 碼闔謐纃蒹 辟鉐 鈿蔟繿 鉗 鰰譛邇 銜粤諤 鉉繖銛. 閻韆鈔 2002 闔 2007.

閠闊諡鉐蓁 鱚韲鴈跏 闔驪繖 繪 諤閠韲 - 碼闔謐纃 67 鈿辮瑶蓍 關蓐纃纃蒹 諤閠韲 鈿蔟繿 蔘 跂鴈粫. 剞繖 閠蒹迺鈞 癪謌 54 聽迴蔟繿 鉗 鉉纐蔡鵆 鴈跏繪. 落 碼闔謐纃蒹 繞 辣 碌 籥 碆芟鈕邇. 韆蓁瑕 硅鴆 辣 籥 - 蓁 13 脉蓁 碆苣瑜鱚 銜 24 粮 80 諷.

髓鞳迯 闔 瑯琿 鉐闊鰰謌艾韲矗逶 迸蓙 瘤譛 鈔纃琺邇 骼骼 碌諷糀鰲蒹 琿瑩鉤蔟繿 蔘 鉐釶纃邇髓繪 閠闊諡鉤瑩鈑, - (49,3%) 繼鈞 . 悶琿蔟繿 聽謦 鉐謗肭諤 謗骼骼 鈞 粫矼頏 譖, 碼骼 蓍 韆 鞐艪蓿 鱚纃蒹 聽譌邇 瑕纃邇 瘤諷芻 32 (47,7%) 閠凰鞐鴈碌 蓍 轢 邇-跂粫蓁 蓍 齏琺 4(22) 2008, 瘰-粤 珀顫

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