| 摘要 |
medicine. SUBSTANCE: method involves performing transparietal puncture of the central areas of dilated intrahepatic biliary tree under ultrasonic control. Safe J-conductor is introduced into the biliary tree visualized by means of contrasted cholangiography. The conductor is moved in retrograde direction towards the distal regions of the biliary tree with the bile ducts of the II-IV order of the anterolateral hepatic segments. Then, proportional catheter is introduced using the J-conductor having end face opening as guide member. The J-conductor is removed and proportional needle conductor having one end sharpened and the opposite end flexible is introduced through the catheter. Catheterized bile duct puncture is carried out from inside under X-ray control. The needle is pulled until its opposite flexible end enters the biliary tree. Next to it, the catheter is pulled beyond the area of the biliary tree and left in the hepatic parenchyma for 2-3 days for sealing the puncture canal with autoblood. The needle conductor is moved in retrograde direction as close as possible to the gallbladder obstruction zone. Cholangiostomy drain possessing shape memory property is set according to Seldinger method. The drain tube repeats the path of the primarily punctured intrahepatic bile duct from its distal region to the obstruction zone. EFFECT: enhanced effectiveness of external transparietal drainage of the bile ducts. 2 cl, 5 dwg
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