DOPPLER ASSESSMENT OF HEPATIC HEMODYNAMICS IN OBSTRUCTIVE JAUNDICE OF VARYING SEVERITY

Introduction. Obstructive cholestasis of benign etiology continues to be a significant medical and social problem. The progressive increase in the number of patients with gallstones in the biliary system, along with the rising frequency of intraoperative biliary tract injuries during laparoscopic procedures, contribute to the high incidence of this pathology. Early diagnosis verification and appropriate selection of treatment strategy significantly influence the outcome of the disease. Objective of the study: to optimize outcomes of comprehensive therapy for patients with obstructive cholestasis by prioritizing minimally invasive surgical techniques based on current imaging methods. Materials and methods. The clinical study included 428 patients with obstructive cholestasis who underwent inpatient treatment between 2015 and 2024 at the clinics of the Surgery and Radiology Departments of Samarkand Medical University. All patients underwent an extensive clinical, laboratory, and instrumental examination: ultrasound scanning with blood flow assessment, MR cholangiopancreatography, endoscopic and percutaneous cholangiography. Results. A multi-stage diagnostic protocol was developed to determine the genesis of biliary obstruction and the degree of hepatocellular insufficiency. Study of portal hemodynamics by duplex scanning revealed a significant decrease in the peak velocity of venous outflow by 1.3-1.7 times in moderate and severe cholestasis. The use of a personalized approach to the selection of decompression methods ensured a reduction in the frequency of surgical complications from 26.6% to 19.5%, and the mortality rate from 6.5% to 4.05%. Conclusion. An integrated approach to diagnosing obstructive colestasis using advanced imaging technologies and individualized therapeutic tactics with an emphasis on щадящие methods ensure improved clinical outcomes in this cohort of patients.