METHOD FOR RETROGRADE SELECTIVE CANNULATION OF CHOLEDOCHUS ACCOMPANYING ENDOSCOPIC PAPILLOSPHINCTEROTOMY

FIELD: medicine.SUBSTANCE: invention refers to medicine, namely to hepatosurgery. Laparoscopic approach to abdominal cavity is performed. Gallbladder is visualized. Cystic duct is isolated and exposed. Clip above the intersection of the cystic duct is applied. At 0.5 cm below the clip using a laparoscopic scissors incision of the cystic duct to the required diameter of lumen of 5 mm is performed. Polymeric biliary catheter for cholangiography is presented in a clamp for cholangiography. Clamp with the catheter is inserted into the abdominal cavity through the trocar in the right hypochondrium, wherein the catheter tip is positioned opposite the opening in the pancreatic duct. Catheter is inserted through the hole in the pancreatic duct through 5 mm in transient movements of the assistant. Under the control of an intraoperative x-ray installation, the catheter is delivered through a cystic duct into a common bile duct. Cholangiography is performed through the catheter by contrast preparations and the calculi are visualized. Catheter tip is delivered into the duodenum. Endoscopic string is inserted through the catheter. Duodenoscopy is performed by visualizing a string in an intestinal lumen. Papillotome is passed through the duodenoscope passage, then the papillotome is "put on" the string and introduced into the lumen of the common bile duct, after which the string is removed. Gas is desulphurated from abdominal cavity. That is followed by papillotomy and removal of concrements from the common bile duct. Endoscope is used to remove gas from the intestine and insufflate the gas into the abdominal cavity. Intersected cystic duct is clipped by two clips below the level of intersection, crossed completely and cholecystectomy is performed.EFFECT: method enables accurate catheter navigation, requires no additional non-standard equipment, accelerates papillotomy.1 cl, 7 dwg Изобретение относится к медицине, а именно к гепатохирургии. Выполняют лапароскопический доступ в брюшную полость. Визуализируют желчный пузырь. Выделяют и обнажают пузырный проток. Накладывают клипсу выше пересечения пузырного протока. На 0,5 см ниже клипсы с помощью лапароскопических ножниц производят надрез пузырного протока до необходимого диаметра просвета 5 мм. Полимерный билиарный катетер для холангиографии проводят в зажим для холангиографии. Зажим с катетером проводятся в брюшную полость через троакар в правом подреберье, при этом кончик катетера позиционируют напротив отверстия в пуз