Current aspects of moderate and severe obstructive jaundice and surgical treatment strategies

The article presents a review of literature on pathophysiological, pathomorphological and clinical-biochemical changes observed in moderate to severe obstructive jaundice. This condition is characterized by pronounced manifestations of cholestasis, cholemia and acholia, and is complicated by varying degrees of hepatic insufficiency, hepatic encephalopathy, cholangitis, biliary sepsis, and gastrointestinal bleeding. The principles of surgical management for this patient category are described in detail, focusing on various interventions in terms of scope and nature, within the framework of a two-stage approach. The first stage involves preliminary biliary decompression, followed by either radical or palliative surgical intervention in the second stage, combined with complex intensive conservative therapy.