DIAGNOSIS AND MODERN METHODS OF TREATMENT OF CHOLELITHIASIS, COMPLICATED BY MECHANICAL JAUNDICE (LITERATURE REVIEW)

Choledocholithiasis complicating gallstone disease, together with the resulting obstructive jaundice, remains one of the most pressing and challenging problems in hepatobiliary surgery. Surgical interventions performed against a background of marked metabolic, coagulopathic and immunological disturbances carry a high operative risk, re­quiring individualization of surgical tactics. This review analyzes publications of the last decade and systematizes minimally invasive treatment options for choledocholithiasis complicated by obstructive jaundice, including endo­scopic retrograde cholangiopancreatography with sphincterotomy, laparoscopic choledocholithotomy, percutane­ous transhepatic drainage, and single-stage versus two-stage tactics. Scoring systems for predicting early postoper­ative complications are discussed, including the Halperin severity classification of obstructive jaundice, the BISAP score, and the Charlson comorbidity index. The literature analysis indicates the need to develop a unified, statistically validated prognostic scale and to refine individualized approaches to selecting surgical tactics.