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Article describes the experience of X-ray-surgical treatment of patient with clinical and laboratory manifestations of cholestasis without a concomitant expansion of bile ducts. In anamnesis of disease - left-sided hemihepatectomy, hepaticojejunostomy on wireframe transhepatic drainage for treatment of portal cholangiocarcinoma III-b, 6 courses of adjuvant chemotherapy. Frame-drainage was removed after 6.5 months after surgery and 2 weeks before this hospitalization. Bilirubinemia (bilirubin 394.89 (233,00-161,89) mol/L) with signs dysproteinemia, cytolysis and anticoagulation were marked during the hospitalization. Lack of pneumobilia during sonography suggested that the most likely cause of cholestasis is a violation of the biliodigestive anastomosis patency Antegrade biliary decompression led to the development of hepatic failure, which was successfully treated by syndromic intensive therapy Following antegrade balloon dilatation of biliodigestive anastomosis area with its external-internal frame-drainage let us to eliminate clinical and laboratory manifestations of obstructive jaundice.

Conclusion: the need for a surgical biliary decompression in cancer patients with cholestasis without a significant expansion of bile ducts with a decrease of functional reserves of the liver is accompanied by the risk of development or progression of liver failure, which leads to complexity and ambiguity of the choice of treatment strategy in these patients.


1.    Yurchenko V.V. Javljaetsja li suprastenoticheskaja dilatacija objazatel'nym simptomom narushenija ottoka zhelchi? [Is suprastenotic dilatation a mandatory symptom of impaired bile outflow?] Vestnik rentgenologii i radiologii. 2015; 3: 18-22. [In Russ]. (АНГИОЛОГИЯ.ру) - портал о диагностике и лечении заболеваний сосудистой системы