Opportunities of the Medicamental Correction of the Postcholecystectomy Disorders of the Microbiocenosis of the Colon at the Polyclinic Stage


Cite item

Abstract

Relevance Laparoscopic cholecystectomy remains the leading treatment for gallstones. This article contains information about the state of the colonic microbiota after undergoing laparoscopic cholecystectomy. According to the literature, usually 96% of patients noted improvement in health in the first 30 days after surgery. Later, when they try to expand the diet, 37% of patients report disorders associated with the presence of intestinal dysbiosis. Materials and methods The study results are based on an analysis of the microbial status of the 179 patients receiving outpatient treatment at the outpatient hospital №4 during first 3 months after surgery. The trial showed that in the early period is characterized by a complete destabilization of the microbial balance in the colon. The correction of dysbiotic disorders with prebiotics, such as inulin and butyric acid is perspective. Results and their discussion The results of the study clearly indicated that the majority of patients in the early period after laparoscopic cholecystectomy observed clinical symptoms of colon such as flatulence (in 41.9% of cases), constipation - in 30.7% of cases, much less - diarrhea in 14.5% of patients. Alternating constipation and diarrhea was observed in 9.5% of patients. Conclusion Intestinal microbiota characterized by a total destabilization of the bacterial balance in 88.3% of patients with a prevalence of 2 degrees of dysbiosis. The use of butyric acid within 1 month after cholecystectomy helps to restore microbiota in 74.5% of patients and require further treatment. The use of drug-butyric acid for 3 months normobiotsenoza possible to achieve recovery of the colon in 91.5% of patients.

About the authors

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Author for correspondence.
Email: surgery-v@yandex.ru
MD, Professor, Corresponding Member of the RANH, Head of the Department of General Surgery, Director of the Institute of Surgical Infection of Voronezh State Medical Academy named after N.N. Burdenko, Honored Inventor of the Russian Federation, Chairman of the Voronezh Branch of the Russian Society of Surgeons.

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: author@vestnik-surgery.com
MD, Professor of the Department of General Surgery of Voronezh State Medical Academy named after N.N. Burdenko, Honored Doctor of the Russian Federation.

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: dr_dasha@list.ru
head of the surgery department, Voronezh outpatient hospital №4

References

  1. Voronina O.V. Korrektsiia disbioza u bol'nykh posle
  2. operatsii na organakh zheludochno-kishechnogo trakta
  3. [Correction of dysbiosis in patients after operations on the
  4. gastrointestinal tract]. Cand. Diss. (Med. Sci.). Moscow,
  5. ; 20. (In Russian)
  6. Dadvani S.A. Zhelchnokamennaia bolezn' [Cholelithiasis].
  7. Moscow: GEOTAR-Media Publ., 2009; 175. (in Russ.).
  8. Lazebnik L.B. Potrebnost' v medicinskoj pomoshchi posle operativnyh vmeshatel'stv na
  9. zheludke i zhelchnom puzyre (obzor literatury i
  10. nashi sobstvennye dannye [The need for medical care after surgery on
  11. the stomach and gall bladder (review of the literature and
  12. our own data)]. Ter.arkhiv. 2004; 2: 83–87. (in Russ.).
  13. Malov V.A., Giulazian N.M. Mikrobiocenoza
  14. zheludochno-kishechnogo trakta, sovremennoe sostoyanie problemy [Microbiocenosis of the
  15. gastro-intestinal tract, the current status of the problem.]
  16. Lechashchii vrach. 2007; 66: [www.lvrach.ru]. (in Russ.).
  17. Buianov V.M. Otdalennye rezul'taty laparoskopicheskoj
  18. holecistehktomiya [Long-term results of laparoscopic
  19. cholecystectomy.] Rossiiskii meditsinskii zhurnal. 1998; 1:
  20. -23. (in Russ.).
  21. Merzlikin N.V. Otdalennye rezul'taty laparoskopicheskoj
  22. holecistehktomii u pacientov Zapadno-Sibirskogo regiona. 5
  23. S"s"ezd nauchnogo obshchestva gastroehnterologov Rossii [Long-term results of laparoscopic
  24. cholecystectomy in patients of West Siberian region. 5
  25. S"ezd nauchnogo obshchestva gastroenterologov Rossii]
  26. Proc. 5th Congress of Russian Scientific Society of
  27. Gastroenterologists. Moscow. 2005; 360-362. (in Russ.).
  28. Skvortsova T.E. Kliniko-patogeneticheskie osobennosti
  29. diagnostiki i lecheniia zhelchnokamennoi bolezni u bol'nykh
  30. s narusheniem dvigatel'noi funktsii i mikrobiotsenoza
  31. kishechnika [Clinical and pathogenetic features of the
  32. diagnosis and treatment of cholelithiasis in patients with
  33. impaired motor function and intestinal microbiocenosis].
  34. Cand. Diss. (Med. Sci.). St. Petersburg. 2007; 25. (in Russ.).
  35. Sheviakov M.A. Korrekciya disbioza kishechnika:
  36. sovremennye podhody. [The correction of intestinal dysbiosis:
  37. modern approaches.] Lechashchii vrach. 2007; 6: [www.
  38. lvrach.ru]. (in Russ.).
  39. Iakushev M.F. Funkcional'nyj status pacientov s
  40. zhelchnokamennoj bolezn'yu, perenesshih ehndoskopicheskuyu
  41. holecistehktomiya [Functional status of patients with
  42. cholelithiasis who have transferred endoscopic
  43. cholecystectomy.] Kazanskii meditsinskii zhurnal. 2008; 1:
  44. -41. (in Russ.).
  45. Femia A.P. et al. Deyatel'nost' protivoopuholevye prebioticheskogo inulin, obogashchennyj oligofruktozoj v sochetanii s probiotikami rhamnosus Laktobacilly i Bifidobacteriumlactis na azoxymethane-inducirovannyj kancerogenez tolstoj kishki u krys [Antitumorigenic activity of the prebiotic inulin enriched with oligofructose in combination with the probiotics Lactobacillus rhamnosus and Bifidobacteriumlactis on azoxymethane-induced colon carcinogenesis in rats.] Carcinogenesis. 2002; 23: 1953–1960.
  46. Butzner J.D., Parmar R, Bell C.J., Dalal V. Butirat klizmu
  47. terapiya stimuliruet mukoznye remont v ehksperimental'nom kolite v
  48. krysa [Butyrate enema therapy stimulates mucosal repair in experimental colitis in
  49. rat.] Gut. 1996; 38: 568–573.
  50. Gibson G.R. Selektivnoj stimulyacii bifidobakterij v
  51. tolstaya kishka cheloveka na oligofruktoza i inulin [Selective stimulation of bifidobacteria in the
  52. human colon by oligofructose and inulin.] Gastroenterology.
  53. ; 10: 975–982.
  54. KimY.I. Korotkocepochechnye zhirnye kisloty pri yazvennom kolite [Short-chain fatty acids in ulcerative colitis.]
  55. Nutrition Reviews. 1998; 56: 17–24.
  56. Andoh A. et al. Fiziologicheskie i protivovospalitel'noe roli pishchevyh volokon i butirat kishechnoj funkcii. [Physiological and anti-inflammatory roles of dietary fiber and butyrate in intestinal fuctions.] J. Parenter Enteral Nutr. 1999; 23: 70–73.
  57. Miller S.J. et al. Korotkocepochechnye zhirnye kisloty moduliruyut gen vyrazhenie dlya andotheial sosudistoj molekuly kletochnoj adgezii [Short-chain fatty acids modulate gene expression for vascular andotheial cell adhesion molecules.] Nutrition. 2005; 21: 740–748.
  58. Mortensen P.B. et al. Korotkocepochechnyh zhirnyh kislot v chelovecheskom tolstoj kishki: svyaz' s zheludochno-kishechnogo zdorov'ya i bolezni [Short-chain fatty acids in the human colon: relation to gastrointestinal health and disease.] Scand. J. Gastroenterol. Suppl. 1996; 216: 132–148.

Copyright (c) 2013 ., ., .

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

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies