Natavan Khidirova

Postoperative duodenal fistula is a rare but serious complication after cholecystectomy and nephrectomy. A case of a 58-year-old woman with chronic calculous cholecystitis and right-sided nephrolithiasis who developed a postoperative duodenal fistula with retroperitoneal abscess is presented. Initial conservative management and percutaneous drainage were performed. Endoscopic closure using TTS endoclips and an endoloop was performed after five months of persistent fistula. Complete fistula closure was achieved, confirmed by follow-up endoscopy and CT scan. Endoscopic closure with TTS endoclips and an endoloop is an effective, minimally invasive option for small chronic duodenal fistulas. Over-the-scope clips (OTSCs) were not used due to the small fistula size and well-formed granulation tissue, which allowed for successful closure with conventional endoscopic tools.

This review outlines the historical background to the development of endoprosthetics (stenting) of the large intestine as a distinct field within minimally invasive surgery for colorectal cancer complicated by obstructive intestinal obstruction, and the contribution of Russian and foreign surgeons to the popularization of the method. Given the validity of incorporating stent technology into the treatment strategy for tumor-related colonic obstruction, it has been demonstrated that a two-stage surgical treatment strategy, involving preliminary colon stenting in the first stage and performance of radical surgery in the second, improves immediate and long-term treatment outcomes and enhances patients’ quality of life. It has been postulated that the correct determination of indications for colon stenting has contributed to a reduction in the incidence of postoperative complications from 10.5% to 3.6%, mortality from 13.6% to 2.7%, and an increase in the frequency of primary radical and immediate reconstructive operations from 55% to 66.8%. It has been shown that in stage IV colorectal cancer complicated by acute intestinal obstruction, colon stenting can serve as a definitive palliative treatment method in patients with a short life expectancy. In the context of the oncological aspects of the problem, it has been shown that in patients receiving chemotherapy with monoclonal antibody-based drugs which inhibit the biological activity of vascular endothelial growth and angiogenesis, stenting is contraindicated due to the high risk of stent-induced perforation of the large intestine.

The book is intended for students of medical faculties. The book contains brief information about urgent and common surgical diseases of the heart and blood vessels in Azerbaijani, English and Russian languages. A clinical example is given for each pathology.