RETROSPECTIVE ANALYSIS OF THE TREATMENT OF PURULENT CHOLANGITIS WITH BILIARY SEPSIS
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i3.15559Keywords:
purulent cholangitis, biliary sepsis, retrograde cholangiopancreatographyAbstract
SUMMARY. The treatment of purulent cholangitis with biliary sepsis is associated with high morbidity, serious complications and insufficient effectiveness of existing treatments. Improvement of therapeutic approaches and introduction of new therapies are extremely important for improving clinical outcomes and reducing mortality among patients. A comprehensive approach to treatment, including the use of modern antibacterial drugs, minimally invasive drainage methods and immunomodulatory therapy, is a promising area that requires further research and implementation in clinical practice.
The aim – to analyze retrospectively the optimisation of minimally invasive treatment of biliary cholangitis complicated by biliary sepsis.
Material and Methods. The observation group consisted of 60 patients diagnosed with purulent cholangitis with biliary sepsis. Patients were divided into two groups: Group I comprised 56.6 % of patients who underwent retrograde cholangiopancreatography (ERCP), Group II – 43.4 % of patients who underwent surgery without contrasting the extrahepatic bile ducts. Patients underwent clinical and instrumental studies.
Results. In the analysis of laboratory parameters of group I after surgery, a significant increase in cytolysis markers was observed, which confirms the hepatotoxicity of the contrast agent. The general condition of patients and laboratory markers of the pathological process were monitored in the dynamics. In 24 hours after surgical treatment, an increase in hepatocyte cytolysis markers was observed, which is associated with the toxic effect of contrast on the liver parenchyma; the average values for cytolysis markers were as follows. When evaluating the laboratory data of patients in group II who did not undergo ERCP, significantly lower values of cytolysis markers were observed compared to patients in group I.
Conclusion. The results of treatment of purulent cholangitis with biliary sepsis can reduce the number of bed days by excluding retrograde cholangiopancreatography (ERCP) from the diagnostic programme, which avoids the development of specific complications, both during and after its implementation, as well as avoiding the toxic effects of contrast on the patient’s liver parenchyma. And the use of a combination of Inositol, Vitamin B8 and Lipoic Acid complement and reinforce each other.
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