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Articole multimedia Jurnalul de Chirurgie, Iasi, 2007, Vol. 3, Nr. 2 [ISSN 1584 – 9341]CLINICA DE CHIRURGIECARITASCOLEDOCUL CHIRURGICAL CLASICŞI COLEDOCUL ENDOSCOPICProf. Dr. Eugen BrătucuClinica Chirurgie, Spital CaritasUniversitatea de Medicină şi Farmacie BucureştiSURGICAL VERSUS ENDOSCOPIC CHOLEDOCUS –INDICATION, TECHNIQUES, RESULTS (Abstract): The treatmentof lithiasis of the main biliary duct is still controversial. There aredifferent criterias for the types of treatment: endoscopic, surgicalminimally invasive techniques or open surgery. Based to the experienceof Caritas Department of Surgery, this paper reviews the indicationsand the results of the treatment of lithiasis of main biliary duct.Conclusion: Open surgery was performed in 50% of cases. Thisapproach is also indicated after failure of laparoscopic technique, butthe gold standard of the treatment of the lithiasis of main biliary duct isthe minimally invasive procedures (laparoscopic techniques andERCP).KEY WORDS: BILIARY LITHIASIS, ERCP, LAPAROSCOPYLitiaza coledociana“LAUDATIO” - CHIRURGIA MINIINVAZIVA“SILENCE” - CHIRURGIA CLASICACENUSAREASA?1. O IGNORAM?2. CE PERFORMANTE MAI ARE?3. CE FEL DE SERVICII MAI ADUCE?•NU ESTE UN ELOGIU AL CHIRURGIEI CLASICE•LOCUL CHIRURGIEI CLASICEColedocul litiazic =chirurgie clasicaChirurgia laparoscopica1970 - OGOSHI -> ERCP1974 - CLASSEN -> SE1976 - COTTON -> Clearance endoscopicCOLEDOC ENDOSCOPICDezobstructiatranscisticaColedocolitotomie185
Articole multimedia Jurnalul de Chirurgie, Iasi, 2007, Vol. 3, Nr. 2 [ISSN 1584 – 9341]Litiaza coledociana“PRIMADONNA”CHIRURGIE CLASICA’’CENUSAREASA’’Litiaza coledociana• CHIRURGIE - LAPAROSCOPICA SI CLASICA• ENDOSCOPIE• RADIOLOGIELAPAROSCOPIARADIOLOGIAINTERVENTIONALALAPAROSCOPIARADIOLOGIAINTERVENTIONALACOLEDOCCOLEDOCCHIRURGICALCHIRURGICALCOLEDOCENDOSCOPICEVITAREACOLEDOCOTOMIEICOLEDOCENDOSCOPICEVITAREACOLEDOCOTOMIEICOLECISTECTOMIA CLASICA + DEZOBSTRUCTIE ENDOSCOPICACOLECISTECTOMIA CLASICA + DEZOBSTRUCTIE ENDOSCOPICALAPAROSCOPIACOLEDOCRADIOLOGIAINTERVENTIONALACHIRURGIE CLASICA30%CHIRURGICALLAPARO - ENDOSCOPIECOLEDOCENDOSCOPICEVITAREACOLEDOCOTOMIEIGOLDSTANDARD• COLECISTECTOMIE LAPARO• DEZOBSTRUCTIE LAPARO-ENDOSCOPICACOLECISTECTOMIA CLASICA + DEZOBSTRUCTIE ENDOSCOPICA’’HOLLY PLAN’’186
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