Functional state of the liver after external drainage of bile ducts in patients with a high level of obstructive jaundice.

Abstract

high level of obstructive jaundice, external drainage of bile ducts, poor bile flow (debit), liver status Ключові слова: тяжка механічна жовтяниця, зовнішнє дренування жовчних протоків, дебіт жовчі, функція печінки Ключевые слова: тяжелая механическая желтуха, наружное дренирование желчных протоков, дебит желчи, функция печени Abstract. Functional state of the liver after external drainage of bile ducts in patients with a high level of obstructive jaundice. Kutovyi O.B., Balyk D.V., Kysilevskyi D.O. The results of the examination and treatment of 67 patients with a high level of obstructive jaundice were analyzed. Diagnosis of obstructive jaundice syndrome was based on the data of anamnesis, complaints, physical, laboratory and instrumental research methods. Among the latter we performed ultrasound investigation (USI) of abdominal organs and bile ducts as a screening method, fibrogastroduodenoscopy (FGDS), computed tomography(CT), magnetic resonance cholangiopancreatography (MRCPG) was carried out if necessary. The cause of a high level of obstructive jaundice: pancreatic head cancer-27 (40.3%); choledocholithiasis-21 (31.3%); Klatskin tumour-5 (7.5%); cancer of the large duodenal papilla-4 (6.0%); chronic pseudotumor pancreatitis-4 (6.0%); choledoch cancer-3 (4.5%); choledochal stricture-3 (4.5%). The first stage of treatment started from the implementation of percutaneous and hepatic external drainage of the bile ducts under ultrasound control. The functional state of the liver was evaluated according to the level of total bilirubin and its fractions, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP). The researches were performed at the admission of patients to the clinic and on day 1, 3 and 7 after external drainage of the bile ducts. Patients were divided into 2 groups, depending on the bile flow rate on the first day after decompression of the biliary tract. It was concluded that the degree of hepatitis in the early period after the performed procedure is directly associated with the bile flow rate during the first day after external drainage of the bile ducts.