STATE OF PROSTHETIC BED TISSUES AND LONG-TERM RESULTS OF DENTAL PROSTHETICS IN PATIENTS WITH DISEASES OF THE HEPATOBILIARY SYSTEM

Background. Predicting the immediate and long-term results of treatment is an urgent problem of modern medicine. The prognosis of complex dental treatment is influenced by many factors. Among the main ones: features of the individual's anatomy and physiology, the type and method of the chosen treatment, the doctor's qualification, features of the patient's psychological profile, the presence of concomitant pathology, and so on. Each of the factors must be considered separately to understand the mechanism and the strength of its impact. Relevance. Finding out the influence of diseases of the hepatobiliary system on the prognosis of dental orthopedic treatment. Objectives. We studied the indicators of patients who re-applied for replacement of an existing dental prosthesis. The study group consisted of patients with liver and biliary tract diseases, and the control group consisted of patients without concomitant General somatic pathology. The terms of use of the prosthesis, the number and severity of treatment complications, and the state of the prosthetic bed were evaluated. Standard clinical and paraclinical diagnostic methods, corresponding pathology, cone-beam computed tomography and statistical analysis methods were used as research methods. Results. The correlation of the terms of use of various types of dentures with the presence of liver and biliary tract diseases in the anamnesis was determined. The dependence of the structure of bone tissue and its density on the presence of the considered pathology was revealed. Conclusion. The obtained data can be applied by orthopedic dentists in the near and long-term prognosis of the result of treatment of patients with partial loss of teeth and concomitant diseases of the hepatobiliary system.

The place of cholespasmolytics in the conservative treatment of diseases of the biliary tract in children

The article presents modern data on etiology and pathogenesis of biliary tract diseases in children. Clinical forms of diseases are described, taking into account the anatomical and physiological age-related features of a child’s organism. The features are shown of conservative and drug therapy of biliary tract diseases in children. We present our own experience in the treatment of pain and dyspeptic disorders in children with biliary tract diseases against the background of various biliary dysfunctional disorders and associated diseases of the upper gastrointestinal tract. The article is intended for pediatricians, gastroenterologists, surgeons, and internists.

MODERN TECHNOLOGIES FOR THE DIAGNOSIS OF BILIARY TRACT DISEASES COMPLICATED BY OBSTRUCTIVE JAUNDICE

Summary. Introduction. Diseases of the biliary tract can have a malignant, incendiary and traumatic etiology and be accompanied by a syndrome of obstructive jaundice. Objective: to study the effectiveness and specificity of modern technologies for the diagnosis of biliary tract diseases complicated by obstructive jaundice. Materials and research methods. We analyzed the instrumental examination of 118 patients with biliary tract diseases complicated by obstructive jaundice. Results and its discussion. Ultrasound is the first screening test in the diagnosis of biliary tract diseases. Ultrasound was performed in 74 (62.7 %) patients. The sensitivity of ultrasound as an indicator of biliary tract was 74.3 %. In 74.3 % (55 patients), an ultrasound scan was sufficient to make the correct clinical diagnosis. Multispiral computed tomography (MSCT) is an indispensable diagnostic method and method for predicting the volume of surgical intervention for malignant neoplasms of the organs of hepatopancreatic zone. MSCT performed in 59 (50 %) patients. The diagnostic accuracy of MSCT for cholangiocarcinoma of various localization was 91.5 %. Endoscopic examinations were performed in 31 (26.3 %) patients. Endoscopic retrograde cholangio-pancreatography, based on the results of which, if there are indications for further performance, endoscopic papillosphincterotomy, can be considered the method of choice in the diagnosis and stage-by-stage treatment of obstructive jaundice of gallstone etiology. Conclusions. In diseases of the biliary tract, complicated by obstructive jaundice, it is first necessary to perform an ultrasound scan. The highest diagnostic accuracy of ultrasound showed in benign diseases, especially with choledocholithiasis — 94.5 %. In case of insufficient information, MSCT should be used. In the presence of X-ray non-contrast calculi, the use of MSCT is impractical, the sensitivity is 80 %. The highest diagnostic accuracy of MSCT was shown for malignant neoplasms of the urinary tract — 91.5 % and is the method of choice in the diagnosis of the prevalence of tumors and its invasion in adjacent anatomical structures and major vessels.

Percutaneous Transhepatic Biliary Interventions

Biliary tract interventions remain indispensable procedures for treatment of a wide arena of biliary tract pathologies. The increased use of endoscopic retrograde cholangiopancreatography (ERCP) for biliary tract evaluation and intervention has resulted in fewer patients requiring percutaneous transhepatic biliary interventions. However, there remains a subset of patients in whom ERCP is not feasible. Interventional radiologists play an important role in the management of biliary pathologies in such patients who cannot be benefited by endoscopic means. These interventions may at times be challenging; hence, awareness of normal and variant biliary tract anatomy and the variety of biliary tract interventions make the job easy. This article reviews the role of percutaneous transhepatic interventions in the management of a variety of biliary tract diseases, both benign and malignant, general indications and contraindications, preprocedural evaluation, and technical considerations specific to indications.