Plasma Levels of Bile Acids and Level of Pressure in the Stomach and Duodenum after Cholecystectomy


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Abstract

Relevance At present, the frequency of operations on the gallbladder and biliary tract is constantly increasing. However, the results after removal of the gallbladder are contradictory and not always accompanied by a pronounced positive effect. The purpose of the study To study the results of cholecystectomy on the basis of data дуоденометрии, ultrasound hepatopancreatobiliary zone, estimates of the spectrum of bile acids in the blood plasma and secretory activity of the pancreas. Matherials and methods The results of cholecystectomy were traced for 10 years after the operation. The consequences of cholecystectomy were assessed by measuring plasma levels of bile acids, the levels of pressure in the stomach and duodenum, by evaluating the changes in the pancreas and stomach. Results and their discussion We detected that plasma levels of lithocholic, deoxyholic and taurodeoxyholic acids were increased by 44% during ten years after cholecystectomy. At the same time, proportions of glycocholic and tauroursodeoxyholic acids decreased by 21.5% in 5 years after the surgery. The changes in plasma levels of bile acids were accompanied by the changes of pressure in the stomach and duodenum. It was established that the most pronounced deviations were observed in the distal duodenum. The level of pressure in this area exceeded the norm by more than 2.8 times. The increase of the intestinal pressure was accompanied by the widening of pancreatic ductals in 9.5% of cases and by the increased ultrasound echogenicity of the structure in 93% of cases. In all the cases, lymphofollicular hyperplasia of gastric antral mucosa with a high degree of helicobacter pylori contamination was detected. Conclusion Сhange in the spectrum of bile acids in the plasma and blood pressure in the duodenum, apparently, is one of the factors in the pathogenesis of chronic pancreatitis after cholecystectomy. The results presented here to a certain extent can be considered as criteria for medical correction of violations occurred in the late postoperative period.

About the authors

Yaroslavl State Medical Academy, 5 Revoliutsionnaia Str., Yaroslavl, 150000, Russian Federation

Author for correspondence.
Email: author@vestnik-surgery.com
MD, Professor, Head of the Department of Hospital Surgery, Yaroslavl State Medical Academy, Honored Doctor of Russia, member of the Russian Academy of Natural Sciences

Yaroslavl State Medical Academy, 5 Revoliutsionnaia Str., Yaroslavl, 150000, Russian Federation

Email: lukaleon2009@gmail.com
MD, postgraduate student, Department of Hospital Surgery, Yaroslavl State Medical Academy. 

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