Pathological syndromes of the biliary tract decompression

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Abstract

Background: The increased incidence of cholelithiasis and tumoral lesions of the hepatopancreatoduodenal zone leads to an increase in the number of patients with obstructive cholestasis.

Aims: To identify the spectrum of pathological conditions developing after decompression of the biliary tract in obstructive cholestasis and to develop an effective pathogenetically determined algorithm for treating patients.

Methods: The results of the examination and treatment of 216 patients with obstructive cholestasis, who underwent various options for decompression of the biliary tract, were analyzed. Obstructive cholestasis of a tumor genesis was present in 112 (51.8%) patients, benign cholestasis in 104 (48.2%). The main group included 112 patients, the comparison group included 104 patients. A two-stage tactics was applied in 133 (61.6%) cases, 83 patients (38.4%) were operated in one stage. The treatment results were compared for the experimental group (n=112) in which a pathogenetically based algorithm was applied and for the control group (n=104) receiving a standard therapy.

Results: Accelerated decompression syndrome developed in 31 (14.3%) cases, of those 26 in the comparison group, 5 in the main group. Disorders of the water and electrolyte balance occurred in 32 (46.4%) patients with complete external bile diversion. Digestion remodeling syndrome was present in 44 patients from 117 patients with external bile diversion.

Conclusions: It has been shown that the pathogenetically based therapy after biliary decompression significantly reduces the number of complications in the postoperative period.

About the authors

Rasul T. Mejidov

State Budget Educational Institution “Dagestan State Medical University”

Email: okhirurgiya@bk.ru
ORCID iD: 0000-0002-9662-6520

MD, Dr. Sci. (Med.), Professor

Russian Federation, 1, Lenin Square, 367000, Makhachkala, Dagestan Republic

Saadat Magomedova

Clinic for General Surgery FSBEI HE "DGMU" Ministry of Health of the Russian Federation, Makhachkala.

Author for correspondence.
Email: saadat_leon@mail.ru
ORCID iD: 0000-0002-0156-679X

сandidate of medical siences, assistant of the department of general surgery, FSBEI HРE "DGMU" of the ministry of health of the Russian Federation.

Russian Federation, Makhachkala st. Lenina 1

Elmira P. Mamedova

State Budget Educational Institution “Dagestan State Medical University”

Email: elma.1973@mail.ru
ORCID iD: 0000-0002-7649-1702

Senior Laboratory Assistant

Russian Federation, 1, Lenin Square, 367000, Makhachkala, Dagestan Republic

Asli Z. Abdullaeva

State Budget Educational Institution “Dagestan State Medical University”

Email: doct.asli@mail.ru
ORCID iD: 0000-0002-8888-4861
SPIN-code: 3985-9176

MD, Cand. Sci. (Med.)

Russian Federation, 1, Lenin Square, 367000, Makhachkala, Dagestan Republic

Umukusum A. Nasibova

State Budget Educational Institution “Dagestan State Medical University”

Email: Uma4kaa1985@mail.ru
ORCID iD: 0000-0002-5705-3918

Assistant

Russian Federation, 1, Lenin Square, 367000, Makhachkala, Dagestan Republic

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Supplementary files

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2. Fig. 1. Magnetic resonance cholangiogram, 3D-reconstruction: а — periampular tumor (arrow); б — a concretion in the bile duct (arrow).

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3. Fig. 2. Multispiral computed tomography with contrast: distal block of the biliary tract (arrow).

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Copyright (c) 2021 Mejidov R.T., Magomedova S., Mamedova E.P., Abdullaeva A.Z., Nasibova U.A.

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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