FEATURES OF THE MORPHOMETRIC CHANGES OF THE HEMOMICROCIRCULATORY CHANNEL OF THE DUODENUM IN THE CONDITIONS OF EXPERIMENTAL OBSTRUCTIVE COLESTASIS AND AFTER ITS CORRECTION USING CHOLEDOCHODUODENOSTOMY AND ENTEROSORPTION
DOI:
https://doi.org/10.11603/1811-2471.2024.v.i2.14720Keywords:
obstructive cholestasis, duodenum, microcirculatory channel, enterosorbentAbstract
SUMMARY. With obstructive cholestasis, the occurrence of an intrahepatic block, an increase in pressure in the portal system and the progressive development of portal hypertension, which in turn affects the microcirculatory channel of the duodenum, are observed. The nature of changes in the vascular bed of the duodenum in this pathology requires a more detailed study.
The aim – to analyze the effectiveness of the use of enterosorbents in combination with choledochoduodenostomy and their effect on functional changes in the vascular bed of the duodenum in obstructive cholestasis.
Material and Methods. From the first day of decompression of the biliary tract, there is an increase in the level of endogenous intoxication, which has a significant effect on the restoration of functional and structural changes in the vascular bed of the duodenum. Therefore, in order to reduce the level of intoxication and improve the recovery processes, we studied 23 experimental animals (sexually mature Vietnamese male pigs breed) with 28-day obturation cholestasis, to which 7 days before decompression of the biliary tract, an enterosorbent of the carboline group was added to the diet at the rate of 0.7 g/kg of the animal weight. On the 3rd day after surgical decompression, the vascular bed of the duodenum was examined in 3 experimental animals, after 7 days – again in 3 animals, after 14 days – in 4, and after 28 days – again in 4 animals. In this study, we used such methods as x-ray and the analysis of the architecture of the vascular bed of the duodenum, which was carried out according to the unified method proposed by K. A. Shoshenko. Therefore, the stereometric organization of the vascular beds were analyzed, the type of branching was determined on radiographs, the diameters, the length of the "vascular tee", the main and subsidiary branches, the angles of departure of the latter from the main trunks were also measured. The obtained digital data were processed by the method of variational statistics using the Student's test, and in other cases – using the Mann–Whitney U-test. The difference between the average values was considered reliable when the probability of the alternative hypothesis was at least 95 %.
Conclusions. Thus, the conducted research and obtained results indicate that the correction of obstructive cholestasis by decompression of the biliary tract in combination with enterosorption has a positive effect on the morphogenesis of the duodenum. At the same time, the condition of the hemomicrocirculatory channel significantly improved. Thus, the diameter of arterioles in the mucous membrane of the upper part of the duodenum was equal to (31.2.±0.93) μm, precapillary arterioles – (15.10±0.45) μm, hemocapillaries – (9.80±0.21) μm, postcapillaries – (18.20±0.48) μm, venules – (42.60±2.10) μm.
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