The Algorithm for the Diagnosis and Treatment of Patients with Chronic Opisthorchiasis Complicated with Obstructive Jaundice

Abstract

Relevance The chronic opisthorchiasis is endemic parasitic disease of the West Siberian region. Сhronic opisthorchiasis in 41.6% of cases, followed by biliary hypertension. Creating a diagnostic and treatment algorithm of surgical complications of chronic opisthorchiasis is actual. The purpose of the study Development and evaluation of the effectiveness of treatment and diagnostic algorithm at patients with chronic opisthorchiasis complicated with obstructive jaundice. Materials and methods. The study included 91 patients with chronic opisthorchiasis complicated with obstructive jaundice. Patients are divided into study and control groups. In the study group we applied developed diagnostic and treatment algorithm. We used ultrasound, magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP). In order to decompress the biliary tract used endoscopic, percutaneous transhepatic and surgical drainage of the bile ducts. Results and their discussion Determined five types of architectonic biliary tract in chronic opisthorchiasis. MRCP sensitivity was 97.7%, specificity 83.3% overall accuracy of 96%. The sensitivity of ERCP in the study group was 97.4%, specificity of 100%, the overall accuracy of 97.7% in the control group 92.1%, 100% and 92.7%, respectively. Endoscopic decompression was effective in 84.0% of patients of study group and 80.6% of control group. Conclusions The analysis indicate high information of MRCP and ERCP. Developed diagnostic and treatment algorithm improves the efficiency of endoscopic methods of diagnosis and treatment. Key words Chronic opisthorchiasis, obstructive jaundice, magnetic resonance cholangiopancreatography