DOI: 10.25881/BPNMSC.2020.43.62.009

Authors

Fedorov V.Je.1, Haritonov B.S.1, Aslanov A.D.2, Logvina O.E.2, Naryzhnaja M.A.1, Masljakov V.V.3

1 Federal State Budgetary Educational Institution of Higher Education «Saratov State Medical University named after V.I. Umumovsky» of the Ministry of Health of the Russian Federation, Saratov

2 Federal State Budgetary Educational Institution of Higher Education «Kabardino-Balkarian State University named after H.M. Berbekov» Ministry of Education and Science of the Russian Federation, Nalchik

3 Private institution educational organization of higher education Saratov Medical University «Reaviz», Saratov

Abstract

The work includes 537 patients who were treated between 2010 and 2019 with the diagnosis of bile disease complicated by mechanical jaundice. There were 301 (56,1%) women. Men received less: 236 (43,9%) people. The ratio of women to men in all groups was comparable. The vast majority of the patients were over the age of 60: 207, which was 38,5%. The number of young people under 30 years of age was 43 (8 per cent). Among them were 5 (0,9%) people aged 18 and 19. Over the age of 80, there were 49 (9,1%) people. After decompression of the bile tract 500 (93,1%) of patients, various surgical interventions were performed. Abdominal and retroperitoneal purulent-necrotic complications occur with the same frequency in both groups: 13 cases, amounting to 5,2%, but in the investigated group they concentrated in the group with cholangitis: a quarter of cases. Organ and systemic complications differ by half: after the introduction of personalized tactics, they decreased from 26 (10,4%) cases to 14 (5,6%). The second thing that draws attention to is the “shift” in the number of complications to the group of patients with cholangitis, where the number of purulent local complications after the introduction of the personalized approach decreased from 7 (2,8%) cases of wound nudity to 5 (1,9%) — in the investigated group. In abdominal inflammatory septic processes, the number of complications decreased in persons with postoperative peritonitis from 13 (5,2%) cases to 7 (2,8%), that is, by half. The sick part of such complications in the investigated group — 4 (11,1%) cases, were operated with cholangitis. The third feature of the development of complications is damage and insufficiency on the part of all major organs and systems. In the examined group, the number of cases of such complications even increased from 7 (2,8%) to 14 (5,6%), which is due to organ failure again in patients with cholangitis, the most severe group subjected to surgical treatment.

Keywords: bile disease, mechanical jaundice, management tactics.

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For citation

Fedorov V.Je., Haritonov B.S., Aslanov A.D., Logvina O.E., Naryzhnaja M.A., Masljakov V.V. Tactics of management of patients with complications of bile disease, manifested by mechanical jaundice depending on stages of its development. Bulletin of Pirogov National Medical & Surgical Center. 2020;3-2(15):42-50. (In Russ.) https://doi.org/10.25881/BPNMSC.2020.43.62.009