Shabat H I
Klin Khir. 2013 Jan(1):9-11.
There were examined 59 patients, admitted to hospital for residual choledocholithiasis, complicated by durable (during more than 2 weeks) obturation jaundice, who were treated in 2009-2012 yrs. In 37 patients (the first group) endoscopic papillosphincterotomy was conducted and choledocholithoextraction, in 22 (the second group)--after endoscopic papillosphincterotomy and choledocholithoextraction nasobiliary drainage was performed during 3-8 days. Besides the conventional clinical and instrumental investigations, there were examined also the spectrum of conjugated and nonconjugated biliary acids in the blood plasm, as the indices of the bile toxicity and early markers of hepatic insufficiency occurrence. There was established in the blood serum of both groups of patients the content increase of the biliary acids toxic fractions. In the patients of the second group the toxic fractions of biliary acids disappearance was observed trustworthy earlier, than in patients of the first group.
对2009 - 2012年期间因残留胆总管结石入院且并发持续性(超过2周)阻塞性黄疸的59例患者进行了检查。其中37例患者(第一组)接受了内镜下乳头括约肌切开术及胆总管结石取出术,22例患者(第二组)在内镜下乳头括约肌切开术及胆总管结石取出术后进行了3 - 8天的鼻胆管引流。除了常规的临床和器械检查外,还检测了血浆中结合型和非结合型胆汁酸的谱,作为胆汁毒性指标和肝功能不全发生的早期标志物。两组患者血清中均发现胆汁酸毒性部分含量增加。第二组患者胆汁酸毒性部分的消失明显早于第一组患者。