Operations on the biliary system in liver damage
Damianov, D.
Khirurgiia 48(4): 5-8
1995
ISSN/ISBN: 0450-2167 PMID: 8648950 Document Number: 442787
Emphasis is laid on the correlation existing between liver and biliary apparatus pathology. On the one hand, attention is called to the development of reactive hepatitis in 60-75 per cent of patients presenting complicated cholelithiasis, and in nearly 30 per cent of the forms free of complications. Removal of the biliary pathology leads to complete regeneration of liver parenchyma in 80 per cent of the patients, especially in operation undertaken in opportune time. On the other hand, pathological conditions of the liver aggravate the developmental course and worsen the prognosis of biliary system diseases when operative management of the letter is necessitated. On the basis of personal experience, the unduely elevated risk in combining surgical intervention for biliary pathology with liver cirrhosis (27 observations), cholangiohepatitis (89 observations), and obstructive jaundice conditioned by a benign underlying cause--usually concrement (164 observations), is underscored. In established cholelithiasis it is fully justified to advise early operation. Surgical intervention in liver cirrhosis should be done after adequate preparation only if absolutely necessary. Obstructive jaundice requires urgent operation, within 10 days, as long as the pathomorphological changes are still reversible.