THE RELATIONSHIP BETWEEN THE INTENSITY OF PAIN SYNDROME AND CLINICAL-LABORATORY INDICATORS AFTER USING MINIMALLY INVASIVE TECHNOLOGIES IN THE TREATMENT OF COMPLICATED CHOLEDOCHOLITHIASIS
DOI:
https://doi.org/10.11603/1811-2471.2026.v.i1.16136Keywords:
choledocholithiasis, cholangitis, pancreatitis, laboratory parameters, pain syndrome, surgical treatment, contrast imagingAbstract
SUMMARY. The aim – to establish the relationship between the intensity of pain syndrome and clinical and laboratory indicators in patients with complicated choledocholithiasis depending on the type of minimally invasive intervention.
Material and Methods. A clinical examination was performed and laboratory parameters of 122 patients with choledocholithiasis (CHL), complicated cholangitis (CH) and biliary pancreatitis (BP), were analyzed. Depending on the treatment method, patients were divided into two groups and corresponding subgroups.
The first group (CHL+CH) included two subgroups: comparison subgroup 1a (n=30), which included patients who were treated according to the generally accepted method using endoscopic retrograde cholangiopancreatography (ERCHP), and observation subgroup 1b (n=29), which used a complex treatment method that included preoperative preparation, ataranalgesia, EPST, lithoextraction, and endobiliary stenting of the hepaticocholedochus with a polypropylene stent.
The second group included patients with choledocholithiasis complicated by biliary pancreatitis (CHL+BP), who were also divided into two subgroups according to a similar principle, depending on the chosen treatment tactics.
Results. It was found that in the group of patients with CHL+CH, 72 hours after surgery with prior contrast of the bile ducts, pain intensity was reliably directly associated with levels of gamma-glutamyltranspeptidase (GGTP) and fatty acid-binding protein (L-FABP). In patients with CHL+CH who underwent surgery without prior contrast of the bile ducts, a direct, moderate correlation was found between pain intensity and levels of GGTP, L-FABP, and AST 72 hours after the surgery. In patients with CHL complicated by BP, 72 hours after surgery with prior contrast imaging, pain intensity was significantly and directly associated with GGTP, L-FABP, ALT, and AST levels. At the same time, in patients with CHL+BP who underwent surgery without prior contrast of the bile ducts, a direct relationship was found 72 hours later between pain intensity and all laboratory parameters studied (GGTP, L-FABP, ALT, AST, and total bilirubin).
Conclusions. 72 hours after minimally invasive intervention, there is a significant direct association between pain intensity and GGTP and L-FABP levels in patients with choledocholithiasis complicated by cholangitis, as well as a significant direct association between pain intensity and GGTP, L-FABP, ALT, and AST levels, both with and without prior contrast imaging of the biliary tract.
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Accepted 2026-04-09
Published 2026-04-22
