Dynamics of parameters of hepatodepressive syndrome in patients with mechanical jaundice of tumour genesis after endoscopic and laparoscopic paliative decompression of common bile duct

Authors

  • M. Y. Nychitaylo O. Shalimov National Institute of Surgery and Transplantation
  • A. P. Kondratiuk O. Shalimov National Institute of Surgery and Transplantation
  • Yu. A. Khilko O. Shalimov National Institute of Surgery and Transplantation
  • P. V. Ogorodnyk O. Shalimov National Institute of Surgery and Transplantation
  • A. G. Deinychenko O. Shalimov National Institute of Surgery and Transplantation
  • V. A. Kondratiuk O. Shalimov National Institute of Surgery and Transplantation
  • N. A. Yermak O. Shalimov National Institute of Surgery and Transplantation
  • T. A. Yusupov O. Shalimov National Institute of Surgery and Transplantation

DOI:

https://doi.org/10.11603/2414-4533.2018.3.9448

Keywords:

laparoscopic hepaticojejunostomy, mechanical jaundice, periampullary tumor, hepatodepressive syndrome

Abstract

The aim of the work: to find out the dynamics of indicators of hepatodepressive syndrome in patients with mechanical jaundice of tumor genesis after endoscopic and laparoscopic palliative decompression of the common bile duct.

Materials and Methods. Under observation, between 2011 and 2017 there were 48 patients who, as a result of a comprehensive examination, found incurable tumors against a background of severe mechanical jaundice. All patients performed palliative decompression of the common bile duct: 30 patients – using endoscopic methods; 18 patients – using laparoscopic hepaticojejunostomy. Each subgroup was randomized according to age, sex, duration of the jaundice, and the basic biochemical parameters identified before surgery. Patients were observed for 6 months after decompression. Before surgery, as well as 1, 7 and 14 days, as well as 3 and 6 months in patients, the markers of hepatodepressive syndrome: prothrombin time, total protein and serum albumin values ​​were determined according to well-known methods.

Results and Discussion. Laparoscopic decompression of the common bile duct by forming hepaticojejunostomy in comparison with endoscopic methods is accompanied by a rapid restoration of the functional state of the liver, which is manifested by a constant decrease in prothrombin time of INR and an increase in serum total protein and albumin contents in 3-6 months after decompression. On the background of endoscopic decompression in this period, the prothrombin time and the INRs are statistically significantly higher, the serum total protein and albumin content is lower compared to laparoscopic decompression. 3-6 months after intervention under endoscopic decompression, hepatodepressive symptoms are significantly deteriorating, which is associated with the development of 30% of patients with complications.

References

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Published

2018-10-17

How to Cite

Nychitaylo, M. Y., Kondratiuk, A. P., Khilko, Y. A., Ogorodnyk, P. V., Deinychenko, A. G., Kondratiuk, V. A., … Yusupov, T. A. (2018). Dynamics of parameters of hepatodepressive syndrome in patients with mechanical jaundice of tumour genesis after endoscopic and laparoscopic paliative decompression of common bile duct. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (3), 91–99. https://doi.org/10.11603/2414-4533.2018.3.9448

Issue

No. 3 (2018)

Section

EXPERIENCE OF WORK

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