[The diagnosis and treatment of cholangiolithiasis after cholecystectomy]

Results of complex examination and treatment of 138 patients with postcholecystectomic cholangiolithiasis were analyzed. Residual cholangiolithiasis was diagnosed in 104 (75.4%), recurrent--in 34 (24.6%) patients. Differential-diagnostic symptoms of residual and recurrent cholangiolithiasis are specifiEd. Diagnostic and curative algorithm was developed, criteria of choice of curative (instrumental or surgical) methods were clarified. Mini-invasive surgeries (endoscopic papillosphincterotomy, suprapapillar choledochoduodenostomy, dissection of stenosed choledochoduodenoanastomosis, percutaneous transhepatic cholangiostomy, lithoextraction through external bile fistual, mechanical and laser lithotripsy, nasobiliar drainage) from different diapeutic approaches were performed in 137 (99.3%) patients. Diapeutic instrumental procedures were effective and final in 91.9% cases (in residual cholangiolithiasis--94.2%, in recurrent--82.4% cases). Lethality was 0.7%.