[The surgical treatment of patients with mechanical jaundice]

Bile-diverting operations in 386 patients with obstructive jaundice are analysed. It was caused by benign diseases in 202 patients (group 1) and by malignant tumors of the biliary tract and pancreas in 184 patients (group 2). Laparoscopic cholecystostomy was carried out in the first stage of treatment in each third patient. In patients of group 1 choledocholithotomy was the main operation performed for restoration of the flow of bile, it was combined with external drainage of the biliary tract in 54 patients, supplemented by transduodenal papillosphincterotomy in 30 patients, choledochoduodenostomy was carried out in 30 patients. The flow of bile was restored in group 2 patients by forming biliodigestive anastomoses. The most frequent among them were cholecystojejunostomy (38) and choledochoduodenostomy (31). Laparoscopic cholecystostomy was the most expedient operation in 61 patients with a spreading neoplastic process.