Summary. Aim. To study the condition of the phagocytic part of immunity in cholangitis. One of the main ways of elimination of bacterial contamination of the body is the work of the immune system, namely phagocytosis. This especially applies to acute and chronic cholangitis. Materials and methods. Depending on the magnitude of pathological changes in the biliary system, we have identified three groups of patients in whom cholangitis occurs in conditions that progress and worsen. Group I – cholangitis in conditions of choledocholithiasis, group II – cholangitis in conditions of iatrogenic strictures of the main bile ducts, and group III – cholangitis in conditions of already performed reconstruction of the duct system. The functional activity of phagocytic cells was studied. Results and their discussion. It was established that the functional capabilities of neutrophils are depleted in proportion to the severity of cholangitis and its duration. In case of chronic undulating cholangitis, there is an insufficiency of the phagocytic link, phagocytes work on the verge of exhausting their reserve capabilities. Adhesion forces and the potential of intracellular lysosomal enzymes are especially affected. Conclusions. The functional capacity of phagocytic cells in cholangitis is characterized by a deficiency, the degree of virulence is to lie down in the severity of inflammation and thrive. The greatest manifestations of changes were revealed in acid-independent mechanisms of phagocytosis, which were characterized by impaired adhesion and the release of intracellular lysosomal enzymes.

Abstract. The morphological status of bile duct cells was studied in patients with acute and chronic cholangitis at different terms of the disease.All patients (32) were divided into 4 groups: up to 5 days, 12-14 days, 28-30 days and 10-12 months. The control group included 12 patients without clinical manifestations of choledocholithiasis. Acute cholestasis is registered in the intrahepatic bile ducts, the maximal severity of which is on first two weeks. In the period of 28-30 days the residual phenomena of acute cholangitis and the growth of connective tissue in the duct walls and around them are registered. In patients with cholangitis, the largest changes in the wall of the choledochus are recorded in 3-5 days from the onset of the disease in the form of edema-desquamative and epithelium necrosis. On 12-14 days marked "attenuation" and demarcation of the inflammatory process, and on 28-30 there’s the appearance of connective tissue in the wall of the choledoch. Patients operated on for chronic recurrent cholangitis for 1 year are documented on the background of the development of choledoch stricture, cholestasis, cholangiosclerosis, and biliary cirrhosis, as a complication.

Summary. Aim. To determine the morphological state of bile duct wall cells in patients with acute and chronic cholangitis at different times after removal of bile hypertension. Materials and methods. During laparotomy surgery, a bile duct wall biopsy was performed in 48 patients with cholangitis, conditionally divided into 4 groups depending on the period of removal of biliary hypertension: up to 5 days, 12-14 days, 28-30 days and 10-12 months. The control group included 12 patients with choledocholithiasis without clinical signs of cholangitis. Results and its discussion. Acute cholestasis was recorded in the intrahepatic bile ducts, the expression of which occurred in the first 2 weeks. In the period of 28-30 days, residual effects of acute cholangitis and proliferation of connective tissue both in the walls of the ducts and around them were recorded. In the bile duct wall of patients with cholangitis, the largest changes were recorded within 3-5 days from the beginning of decompression in the form of edematous-desquamative and necrotic phenomena on the part of the epithelium. On the 12-14th day, “attenuation” and demarcation of the inflammatory process were noted, and on the 28-30th day – the development of connective tissue. In patients with long-term (6-12 months) chronic cholangitis, the phenomena of cholestasis, cholangiosclerosis and biliary cirrhosis of the liver were documented, which were not subjected to regression. Conclusions. The most pleasant for reconstructive interventions after the elimination of cholangitis and biliary hypertension is a period of 3-6 weeks. With prolonged cholangitis, the phenomena of sclerosis and cirrhosis are not regressed.