To sign up for an online consultation, follow the link: https://hirurgia-saratov.ru/onlayn-ko... For questions about in-person consultations and operations, you can write to WhatsApp and Viber at the phone number: +7 (905) 034-76-84 ATTENTION! This video is for educational and informational purposes only. There are contraindications. Before using the recommendations and advice from the video, BE SURE to consult a doctor! Choledocholithiasis video - • Choledocholithiasis. When you can not remove ... Jaundice is the coloring of the skin, mucous membranes and sclera of the eyes in yellow due to the accumulation of bilirubin in them. This accumulation is associated with its increased content in the blood. Jaundice is not an independent disease, but only a consequence of some disease. Where does bilirubin come from? When red blood cells are destroyed, hemoglobin is released, from which bilirubin is formed. This is indirect bilirubin, it is insoluble in water and toxic. Indirect bilirubin enters the liver cells with the bloodstream, where it is converted into a soluble form by a chemical reaction and is called direct bilirubin. Through the bile ducts, direct bilirubin enters the duodenum with bile, and then is excreted with feces, simultaneously coloring the feces brown and urine yellow. Depending on the level of bilirubin utilization at which the cause is located, all jaundice can be divided into three types: suprahepatic, hepatic and subhepatic. To make it easier to understand where the problem lies in the topic of jaundice, I will draw your attention to the diagram. From the name it is clear that with the first type, the problem arises even before bilirubin enters the liver to be converted into a soluble form. Suprahepatic jaundice, it is also called hemolytic, occurs mainly with increased breakdown of red blood cells. Examples of this jaundice include neonatal jaundice and jaundice caused by hemolytic poisoning. The more red blood cells are destroyed, the more indirect bilirubin is formed. The second type of jaundice is hepatic, also called parenchymatous. From the name it is clear that the problem lies in the liver itself. Due to various reasons, mainly viral hepatitis or cirrhosis, liver cells cannot fully process the indirect bilirubin that is formed during the breakdown of hemoglobin, and they also cannot fully remove direct bilirubin into the bile ducts. And the third type of jaundice, which is encountered mainly by surgeons, is subhepatic or mechanical. From the names it is clear that the cause is at the stage of removing soluble bilirubin from the liver into the duodenum. There is a mechanical obstruction to the outflow of bile. That is, if there is an obstruction to the outflow of bile at any level of the biliary tract, mechanical jaundice develops. The causes may vary, but they are mostly stones in the bile duct that have migrated from the gallbladder. Less common causes include tumors of the head of the pancreas and the large duodenal papilla. Bilirubin, especially indirect bilirubin, has a toxic effect on the entire body. Metabolism and blood clotting are disrupted, and encephalopathy develops. With prolonged, progressive jaundice, death occurs from liver failure and metabolic failure throughout the body. Jaundice is diagnosed based on an increase in the bilirubin level in the blood, that is, if the level is above 21 μmol/l. The therapist and the surgeon have two identical tasks: 1) eliminate the cause of jaundice, 2) remove excess bilirubin from the body as quickly as possible and restore liver function.