НОВЫЕ ВОЗМОЖНОСТИ ДИАГНОСТИКИ И ПЕРСПЕКТИВЫ ЛЕЧЕНИЯ ПОРАЖЕНИЙ ПЕЧЕНИ У ДЕТЕЙ

This review presents the current possibilities of diagnosis of children’s liver disease: to define avidity of antibodies to hepatitis A, C for detection early infection, the development of non-invasive panel of serum markers of fibrosis and the introduction of elastography liver, as an alternative to needle biopsy. Indicated promising directions in the therapeutic tactics of viral hepatitis in children associated with the use of combined schemes of parenteral interferon (IF), including pegylated, in conjunction with similar nukleoz(t) ides, IF inducers.В обзоре представлены современные возможности диагностики заболеваний печени у детей: определение авидности антител к вирусам гепатита А, С для выявления раннего инфицирования, разработка панелей неинвазивных сывороточных маркеров фиброза и внедрение эластографии печени как альтернативы пункционной биопсии. Указаны перспективные направления в терапевтической тактике вирусных гепатитов у детей, связанные с использованием комбинированных схем парентеральных интерферонов (ИФ), в том числе пегилированных, в сочетании с аналогами нуклеоз (т)идов, индукторов ИФ

New diagnostic and treatment perspectives of children’s hepatic lesions

This review presents the current possibilities of diagnosis of children’s liver disease: to define avidity of antibodies to hepatitis A, C for detection early infection, the development of non-invasive panel of serum markers of fibrosis and the introduction of elastography liver, as an alternative to needle biopsy. Indicated promising directions in the therapeutic tactics of viral hepatitis in children associated with the use of combined schemes of parenteral interferon (IF), including pegylated, in conjunction with similar nukleoz(t) ides, IF inducers

ENDOBILIARY STENTING WITH LAPAROSCOPIC ASSISTANCE - HYBRID TECHNOLOGY IN COMPLICATED CLINICAL SITUATION

The authors suggest an original method of endobiliary stenting with laparoscopic assistance for reduction of obstructive jaundice in patients with non-operative tumors of hepatopancreaduodenal zone in the case of impossibility of performance of percutaneous or endoscopic decompression of the bile ducts. A recanalization of tumor stricture was carried out with the aid of laparoscopic assistance. A self-expandable metal stent with polymeric covering was implanted in the bile ducts. The proposed method was applied in 5 cases. An adequate decompression of the bile ducts was noted in all cases. The patient’s condition was good after surgery. There weren’t any cases of serious complications or hospital lethality