[The diagnosis of lithiasis of the extrahepatic biliary tract]

The diagnostic approach to 227 patients presenting lithiasis of the extrahepatic biliary ducts is discussed. All patients are diagnosed in the second surgical department of the University Aleksandrovska Hospital over an eleven-year period on the ground of complex examinations, including: clinical, laboratory and instrumental (echography, endoscopic retrograde cholangiopancreatography, cholangiography, computerized tomography) study. As shown by the clinical data analysis, the basic symptoms are pain--in 221 cases (97.35%), jaundice--128 (56.38%), accompanied in most of them by dyspeptic complaints, and in a minor part--by cholangitis manifestations. Of the laboratory data, the most commonly met with are the abnormally increased values of serum bilirubin, alkaline phosphatase, liver tests etc. Of the instrumental methods echography is first and foremost used in the preoperative period, supplemented in certain cases with other methods. Intraoperatively, cholangiography is routinely used for concrement detection.