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


Cite item

Full Text

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. 

References

  1. Eremenko V.P., Maistrenko N.A., Nechai A.I. Gepatobiliarnaia
  2. khirurgiia: rukovodstvo dlia vrachei [Hepatobiliary Surgery:
  3. A Guide for Physicians.] // St. Petersburg. 1999; 268.
  4. Ermolov A.S., Shulutko A.M., Prudkov M.I. Hirurgicheskoe
  5. lechenie ostrogo holecistita u pacientov v pozhilom i starcheskom vozraste [Surgical treatment of acute cholecystitis in elderly and senile age patients.] // Surgery. 1998; 2: 11—13.
  6. Gallinger Iu.I., Timoshin A.D., Movchun A.A., Karpenkova
  7. V.I. Laparoskopicheskaya holecistehktomiya (rezul'taty 350 operacij) [Laparoscopic cholecystectomy (results of 350 operations).] // Annaly NTsKh RAMN. 1993; 2: 44—51.
  8. Galimov O.V., Nurtdinov M.A., Senderovich E.I. Kombinirovannye
  9. laparoskopicheskie procedury dlya zhelchekamennoj bolezni [Combined
  10. laparoscopic procedures for cholelithiasis.] // Messenger surgery.
  11. ; 1: 82—86.
  12. Vetshev P.S., Shkrob O.S., Bel'tsevich D.G.
  13. Zhelchnokamennaia bolezn' [Cholelithiasis.] // Moscow. 1998; 137.
  14. Dadvani S.A., Vetshev P.S., Shulutko A.M., Prudkov M.I.
  15. Zhelchnokamennaia bolezn' [Cholelithiasis.] // Moscow: Dom Vidar-M Publ., 2000; 139.
  16. Ermolov A.S., Dasaev N.A., Iurchenko S.V. Diagnostika
  17. i lechenie holangiolitiaza posle holecistehktomii [Diagnostics
  18. and treatment of holangiolitiasis after cholecystectomy.] // Surgery. 2002; 4: 4—10.
  19. Savel'ev B.C., Vasil'ev V.E., Kulikov V.M., Mishakina
  20. N.Iu. Vybor sposoba holecistehktomii pri ostrom
  21. holecistite [Selecting the method of cholecystectomy for acute
  22. cholecystitis.] // Bulletin of the Russian State Medical University . 2006; 4: 51: 44—46.
  23. Strakhov A.V., Gradusov V.P., Teremov S.A. Sravnitel'naya
  24. ocenka rezul'tatov provedeniya sleduyushchej holecistehktomii pri
  25. hronicheskom kal'kuleznom holecistite [Comparative
  26. evaluation of outcomes of the next cholecystectomy for
  27. chronic calculous cholecystitis.] // Surgery. 2006; 2: 10—13.
  28. Beburishvili A.G., Ziubina E.N. Minimal'no invazivnaya hirurgiya
  29. pri ostrom holecistite u bol'nyh s vysokim hirurgicheskim riskom [Minimally invasive surgery for acute cholecystitis in patients with high surgical risk.] // Analysis of surgical hepatology. 2002; 1: 87.
  30. Rhodes J.,Barnardo D. Uvelichenie reflyuksa zhelchi v
  31. zheludok u pacientov s yazvennoj bolezn'yu zheludka [Increased reflux of bile into the stomach in patients with gastric ulcer.] // Gastroenterology. 1969; 57; 241-52.
  32. Shefer, S., Hauser S., Bekersky I. Regulirovanie obratnoj svyaz'yu biosinteza zhelchnyh kislot u krys [Feedback regulation of bile
  33. acid biosynthesis in the rat.] // J. lipid Res. 11; 404-411.
  34. Nilsell K., Angelin B., Leijd B. Sravnenie ehffektov
  35. ursodezoksiholevoj kisloty i henodeoksiholevoj kisloty na
  36. kinetiku zhelchnyh kislot i sekreciyu zhelchnyh lipidov v organizme cheloveka [Comparative effects of
  37. ursodeoxycholic acid and chenodeoxycholic acid on
  38. bile acid kinetics and biliary lipid secretion in humans.] // Gastroenterology. 85; 1248-1256.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2013 ., .

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