CAUSES OF BILIODIGESTIVE ANASTOMOSIS SUTURE FAILURE

Abstract. Aim. To study the causes of biliodigestive anastomosis (BDA) suture failure, forced to be applied in conditions of cholangitis. Materials and methods. We analyzed 73 cases of BDA application in patients with bile duct obstruction: 20 of them underwent primary reconstruction, 18 underwent reconstruction (i.e. BDA was applied secondarily due to obstruction of the previously applied one), and 35 BDA were applied during pancreatoduodenal resection in the treatment of patients with pancreatic tumors. The causes of suture failure were studied in 18 (24.7%) cases. Results. Most often, suture failure occurred during reconstruction – 7 (38.9%). The ongoing infectious and inflammatory process, suppression of the phagocytic link of immunity and autoimmune reactions in the BDA zone significantly delay reparative processes between the connected tissues. Conclusions. In addition to the complex anatomy, which cannot be influenced, the main negative factors in the quality of reparative processes in the BDA zone are the morphological state of the duct wall connecting to the intestine, expression of inflammation, phagocytic link of immunity and autoimmune reactions.