FUNCTIONAL CHANGES IN THE VASCULAR BED OF THE DUODENUM IN CONDITIONS OF EXPERIMENTAL OBSTRUCTIVE CHOLESTASIS AND METHODS OF ITS CORRECTION
DOI:
https://doi.org/10.11603/2414-4533.2026.1.16104Keywords:
obstructive cholestasis, duodenum, endogenous intoxicationAbstract
The aim of the work: to assess compensatory processes in the duodenum when using the surgical method of choledochoduodenostomy in the treatment of experimentally simulated obstructive cholestasis.
Materials and Methods. The study of the features of compensatory processes in the duodenum during prolonged obstructive cholestasis, which was simulated by ligation of the common bile duct, was conducted. The experiment used 23 male pigs of the Vietnamese breed with 4-week jaundice. The microflora of the duodenum (staphylococci, enterococci, streptococci) was studied. The phenomenon of endogenous intoxication was studied using the number of molecules of average mass. Changes in biochemical parameters in the serum of pigs on days 3, 7, 14 and 28 of simulated obstructive cholestasis were analyzed.
Results. It has been established that the surgical method of choledochoduodenostomy, already a week after the correction of 28-day mechanical jaundice, significantly reduces endogenous intoxication, lipid peroxidation, increases antioxidant protection of organs and the body, improves pigment metabolism and liver function and intestinal biocenosis. Under these experimental conditions, catalase activity normalizes within 14 to 28 days from the start of the experiment.
Conclusions. The conducted studies and the obtained results indicate that the imposition of choledochoduodenal anastomosis in obstructive cholestasis contributes to the reduction of endogenous intoxication and the degree of lipid peroxidation, increases antioxidant protection, and reduces structural changes in the studied organ.
Received: 02.01.2026 | Revised: 03.02.2026 | Accepted: 23.02.2026
References
Pylypchuk VI. Mozhlyvi operatsiyi na zhovchnykh protokakh pry khronichnomu pankreatyti z oznakamy zhovchnoyi hipertenziyi [Possible surgeries on bile ducts in cases of chronic pancreatitis with signs of biliary hyperten-sion]. Shpytalʹna khirurhiya. Zhurnal imeni L.Ya. Kovalʹchuka – Hospital Surgery. Journal named after L.Ya. Kovalchuk. 2016; 27-31. DOI: 10.11603/2414-4533.2016.2.6406. Ukrainian.
Hnatyuk MS, Tatarchuk LV, Hrabchak SO. Osoblyvosti strukturnoyi perebudovy sudyn mikrohemotsyrkulyatornoho rusla dvanadtsyatypaloyi kyshky pry obturatsiynomu kholestazi [Peculiarities of structural reorganization of the microhemocirculatory bed of the duodenum in obstructive cholestasis]. Zdobutky klinichnoyi ta eksperymentalʹnoyi medytsyny – Achievements of Clinical and Experimental Medicine. 2016; 4:36-40. DOI: 10.11603/1811-2471.2016.v0.i4.7073. Ukrainian.
Zheng Y, Xu M, Zheng Y, Xu M, et al. Gallstone disease and increased risk of mortality: two large prospective studies in US men and women. J Gastroenterol Hepatol. 2018; 33:1925-931. DOI: 10.1111/jgh.14212.
Dzyubanovsʹkyy OI, Hudyma AA. Vplyv dekompresiyi zhovchnykh protok na dynamiku zhovchoutvorennya ta zhovchovydilennya pislya eksperymentalʹnoho kholestazu riznoyi tryvalosti [The effect of decompression of the biliary ducts on the dynamics of cholesteatoma and cholesteatoma after experimental cholestasis of different duration]. Klinichna khirurhiya – Clinical Surgery. 10, 2017 66-69. DOI: 10.26779/2522-1396.2017.10.66. Ukrainian.
Oh CH, Dong SH. Recent advances in the management of difficult bile-duct stones: a focus on single-operator cholangioscopy-guided lithotripsy. Korean J Intern Med. 2021; 36(2):235-46. DOI: 10.3904/kjim.2020.485.10.
Ministerstvo okhorony zdorov’ya Ukrayiny [Ministry of Health of Ukraine]. Klinichnyy protokol “Zhovchnokam’yana khvoroba (ZhKKh)” [Clinical protocol “Gallstone disease (GSD)”]. Nakaz MOZ Ukrayiny No 271 vid 13.06.2005 r. (v redaktsiyi 2021 r.). Kyiv. MOZ Ukrayiny. 2021. Ukrainian.
Kravetsʹ, V.V. Morfolohichni zminy tonkoho kyshechnyka pid vplyvom riznykh endohennykh ta ekzohennykh faktoriv (ohlyad literatury) [Morphological changes in the small intestine under the influence of various endogenous and exogenous factors (literature review)]. Visnyk Sumsʹkoho derzh. universytetu. Seriya «Medytsyna» – Visnyk Sumsʹkoho derzhavnoho universytetu. Seriya «Medytsyna». 2008; 1:5-16. Ukrainian.
Boyko V.V. Vybir obsyahu operatyvnoho likuvannya u patsiyentiv iz zakhvoryuvannyamy hepatykokholedokha, uskladnenymy mekhanichnoyu zhovtyanytseyu [Selection of the scope of operative treatment in patients with hepaticocholedochus diseases complicated by mechanical jaundice]. Mizhnarodnyy medychnyy zhurnal – International Medical Journal. 2018; 1(24):33-8. DOI: 10.266779/2522-1392.2018.10.66. Ukrainian.
Ahn KS, Yoon YS, Han HS, Cho JY. Use of liver function tests as first-line diagnostic tools for predicting common bile duct stones in acute cholecystitis patients. World J Surg. 2016; 40:1925-931. DOI: 10.1007/s00268-016-3483-8.18.
Peery AF, Crockett SD, Murphy CC, Jensen ET, Kim HP, Egberg MD, et al. Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2021. Gastroenterology. 2022; 162(2):621-44. DOI: 10.1053/j.gastro.2021.10.020.19.
Guizzetti L, Ma C, et al. Epidemiology and outcomes of choledocholithiasis and cholangitis in the United States: trends and urban-rural variations. BMC Gastroenterol. 2023; 23:254. DOI: 10.1186/s12876-023-02868-3.20.
Li S, Guizzetti L, Ma C, et al. Epidemiology and outcomes of choledocholithiasis and cholangitis in the United States: trends and urban-rural variations. BMC Gastroenterol. 2023; 23:254. DOI: 10.1186/s12876-023-02868-3.
Krytsak MY, Harhula TI, Slabyy OB, Yasinovsʹkyy OB, Kuziv OV, Ihnatishchev MR. Kharakterystyka morfolohichnykh zmin u poperekovomu viddili diafrahmy pry mekhanichniy zhovtyanytsi ta pnevmoperytoneumi [Characteristics of morphological changes in the lumbar part of the diaphragm in cases of obstructive jaundice and pneumoperitoneum]. Arch Balk Med Union. 2025; 60(1):62-8. DOI: 10.31688/ABMU.2025.60.1.06. Ukrainian.
Demircioglu MK, Demircioglu ZG, Cakir O, Yanar K, Ozguven MBY, Atukeren P, Gulcicek OB, Citgez B, Yazici P. Antioxidant effect of Rosa pimpinellifolia L. fruit extract on cholestatic liver injury: an experimental study. Rev Assoc Med Bras. 2024; 70(1):e20230720. DOI: 10.1590/1806-9282.20230720. PMID: 38198394. PMCID: PMC10768672.
Kritsak MY, Dzyubanovsʹkyy IYa, Holovata TK, Harhula TI, Yasinovsʹkyy OB, Palamar SA. Strukturni zminy diafrahmy za umov mekhanichnoyi zhovtyanytsi (eksperymentalʹne doslidzhennya) [Structural changes in the diaphragm under conditions of obstructive jaundice (an experimental study)]. Vidp. Morf. 2025; 31(1):22-9. DOI: 10.31393/morphology-journal-2025-31(1)-03. Ukrainian.
de Freitas Junior S, Bustorff-Silva JM, Ramos CD, Brunetto SQ, da Costa APM, Antunes AG, Biavatti BBV, Franchi Junior GC, Moreira MM, Felix PCG, Miranda ML. Scintigraphic Evaluation of the Impact of Pneumoperitoneum on Renal Blood Flow: A Rabbit Model. J Laparoendosc Adv Surg Tech A. 2019; 29(10):1271-75. DOI: 10.1089/lap.2019.0194. Epub. 2019 Sep. 4. PMID: 31483185.17. Chen HL, Wu SH, Hsu SH, Liou BY, Chen HL, Chang MH. Jaundice revisited: recent advances in the diagnosis and treatment of inherited cholestatic liver diseases. J Biomed Sci. 2018; 25(1):75. DOI: 10.1186/s12929-018-0475-8. PMID: 30367658/ PMCID:
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