Summary

doi: 10.25005/2074-0581-2014-16-4-38-44
Pathogenesis and treatment of endothelial dysfunction in suppurative cholangitis

U.Kh. Gayurov, K.M. Kurbonov, F.I. Makhmadov, K.R. Nazirboev

Chair of Surgical Diseases №1 Avicenna TSMU

The authors analyzed the results of a comprehensive diagnosis and surgical treatment of 120 patients with suppurative cholangitis. A study of markers of endothelial dysfunction in severe acute suppurative cholangitis (n=32) and biliary sepsis (n=24) showed a significant their increase due endotoxin aggression caused by cholangiogenic infection and oxidative stress. Depending on the general condition of patients, the severity of endotoxin aggression and bilirubinemia one- and two-stage treatment with using of modern technology and traditional surgical procedures were performed. Due to severity of endotoxemia and the general condition 61of patients underwent two-stage surgery.

Along with biliary decompression, eliminating the causes of obstruction, pathogenetically substantiated treatment of endothelial dysfunction in suppurative cholangitis is intraportal and

transcholedoheal introduction of antihypoxants and antioxidants (n=24). In the postoperative period, after the complex pathogenetic treatment in 11 (9%) cases observed deaths, the cause of which was progressive liver failure in 8 cases and – acute cardiovascular failure – in 3.

Keywords: suppurative cholangitis, endotoxin aggression, decompression of the bile duct, oxidative stress, endothelial dysfunction.

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