Phatological state after cholecystectomy: from pathogenesis to treatment

Prof. Zvyagintseva T.D., as. prof. Shargorod I.I. Kharkiv Medical Academy of Postgraduate Education.

Considered a pathological condition after cholecystectomy (biliary dysfunction, lesions esophagogastroduodenal zone halogena diarrhea, changes in the microbiome of the intestine). Their availability determines the therapeutic approach, the choice of pharmacotherapy, most adequately relieves the symptoms of these disorders.

Key Words: cholecystectomy, postcholecystectomy syndrome, bacterial contamination, metabolism of bilious acids, principles of treatment.

https://dx.doi.org/10.15407/internalmed2017.02.009

Для цитування:

Zvyagintseva TD, Shargorod II. [Phatological state after cholecystectomy: from pathogenesis to treatment]. Shidnoevr. z. vnutr. simejnoi med. 2017;2:9-15. Russian. https://dx.doi.org/10.15407/internalmed2017.02.009

Download.PDF

1. Agafonova NA. Nevsasyvajushhiesja (kishechnye) antibakterial’nye preparaty v gastrojenterologii: spektr primenenija rifaksimina. Consilium medicum. Gastrojenterologija. 2009;1:61-6. Russian
2. Ardatskaja MD. Sindrom izbytochnogo bakterial’nogo rosta i narushenie processov pishhevarenija i vsasyvanija. Poliklinika. 2009;2:38-40. Russian
3. Ardatskaja MD. Funkcional’nye rasstrojstva biliarnogo trakta: problemy diagnostiki i lechenija. Farmateka. 2012;2:71-7.
4. Anohina GA, Harchenko VV, Opanasjuk ND, Lopuh IJa, Jakubovskaja IA. [Some aspects of the use of preparations of ursodeoxycholic acid, combined with plant extracts, in the treatment of the diseases of the hepatobiliary system]. Suchasna gastroenterologіja. 2014;1(75):49–54. Russian
5. Basarbolieva JV, Stupin VA, Kobesov NV, Vasin VI, Doroshenko DA. [Optimization of diagnostic and treatment algorithm for patients with postcholecystectomic syndrome]. Spravochnik vracha obshhej praktiki. 2015;2:22-30. Russian
6. Vinnik JuS, Serova EV. [Significance of octapeptide cholecystokinin in development of oddi’s sphincter dysfunction of inorganic etiology after cholecystectomy in patients operated for calculous cholecystitis]. Permskij medicinskij zhurnal. 2013;5:78-85. Russian
7. Zvyagintseva TD, Shargorod II. Postholecistjektomicheskij sindrom: disfunkcija sfinktera Oddi. Lіki Ukraini. 2011;2(148):100–6. Russian
8. Zvyagintseva TD, Chernobaj AI. [The pathogenetic correction of biliary pain at postcholecystectomical syndrome and dysfunction of Oddi sphincter]. Suchasna gastroenterologіja. 2012;6(68):87-91. Russain
9. Zvyagintseva TD, Gridnyova SV. [The mechanisms of development and approaches to the treatment of sphincter of oddi dysfunction after cholecystectomy]. Gastrojenterologija. 2014;2:77-81. Russain
10. Ivanchenkova RA. Khronicheskie zabolevaniia zhelchevyvodiashchikh putei. Moscow: Atmosfera; 2006. 416 p. Russain
11. Il’chenko AA. Bolezni zhelchnogo puzyria i zhelchnykh putei: Rukovodstvo dlia vrachei. 2-e izd., pererab. i dop. Moscow: Izdatel’stvo «Meditsinskoe informatsionnoe agentstvo; 2011. 880 p. Russian
12. Il’chenko AA. Pochemu kholetsistektomiia ne vsegda uluchshaet kachestvo zhizni? Farmateka. 2012;17(250):23–9. Russian
13. Kozlova IV, Graushkina EV, Volkov SV. [Clinicofunctional and structural disorders of the gastroduodenal zone after cholecystectomy]. Vrach. 2010;9:72-6. Russian
14. Kucheryaviy YA. [Status post cholecystectomy: gastroenterologist”s perspective]. Meditsinsky sovet. 2013;6:39-44. Russian
15. Kostyuchenko MV. [Sphincter dysfunction in postcholecystectomy patients: current aspects of treatment]. Effective Pharmacotherapy. 2013:31:24–30. Russian
16. Loranskaia ID, Vishnevskaia VV, Malakhova EV. Biliarnye disfunktsii — printsipy diagnostiki i lecheniia. RMJ. 2009;4:246-9. Russian
17. Lialiukova EA, Livzan MA. [Dysfunction of Oddi sphincter and the syndrome of excess increase in the intestine]. Lechaschi Vrach Journal. 2013;1:61-65. Russian
18. Minushkin ON, Maslovskii LV. Diagnostika i lechenie funktsional’nykh rasstroistv billiarnogo trakta. Gastroenterologiia Sankt-Peterburga. 2010;2-3:27–32. Russian
19. Minushkin ON. [Functional dysfunctions of bowels and biliary. Approaches to treatment, antispasmodic agent choice]. Lechaschi Vrach Journal. 2012;2:64-67. Russian
20. Parfenov AI., Krums LM. Kholagennaia diareia: osobennosti patogeneza, kliniki i lecheniia. RMJ. 2009;2:114-8. Russian
21. Toporkov AS. Effektivnost’ selektivnykh miotropnykh spazmolitikov dlia kupirovaniia abdominal’noi boli. RMJ. 2011;28:1752-1760. Russian
22. Charyshkin AL, Badejan VA, Bikbaeva KI. [The results of cholecystectomia in the remote postoperative period]. Siberian Medical Journal. 2011;8:32–34. Russian.
23. Allen A, Flemström G. Gastroduodenal mucus bicarbonate barrier: protection against acid and pepsin. Am J Physiol Cell Physiol. 2005 Jan;288(1):C1-19. PMID: 15591243 DOI: 10.1152/ajpcell.00102.2004
https://doi.org/10.1152/ajpcell.00102.2004
24. Bertók L. Bile acids in physico-chemical host defence. Pathophysiology. 2004 Dec;11(3):139-145. PMID: 15561510 DOI: 10.1016/j.pathophys.2004.09.002
https://doi.org/10.1016/j.pathophys.2004.09.002
25. Binder HJ. Causes of chronic diarrhea. N Engl J Med. 2006 Jul 20;355(3):236-9. PMID: 16855263 DOI: 10.1056/NEJMp068124
https://doi.org/10.1056/NEJMp068124
26. Gerok W. [Pathophysiology of chronic diarrhea]. Praxis (Bern 1994). 2000 Oct 12;89(41):1635-41. German. PMID: 11081364
27. El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014 Jun;63(6):871-80. doi: 10.1136/gutjnl-2012-304269. Epub 2013 Jul 13.
https://doi.org/10.1136/gutjnl-2012-304269
28. Mabrut JY, Collard JM, Baulieux J. [Duodenogastric and gastroesophageal bile reflux]. J Chir (Paris). 2006 Nov-Dec;143(6):355-65. French. PMID: 17285081
29. McColl KE, Clarke A, Seenan J. Acid pocket, hiatus hernia and acid reflux. Gut. 2010 Apr;59(4):430-1. doi: 10.1136/gut.2009.192922.
https://doi.org/10.1136/gut.2009.192922
30. McQuaid KR, Laine L, Fennerty MB, Souza R, Spechler SJ. Systematic review: the role of bile acids in the pathogenesis of gastro-oesophageal reflux disease and related neoplasia. Aliment Pharmacol Ther. 2011 Jul;34(2):146-65. doi: 10.1111/j.1365-2036.2011.04709.x. Epub 2011 May 25.
https://doi.org/10.1111/j.1365-2036.2011.04709.x
31. Oh DS, Hagen JA, Fein M. The impact of reflux composition on mucosal injury and esophageal function. Journal of Gastrointestinal Surgery 2005;10:87–797.
32. Adachi JA, DuPont HL. Rifaximin: a novel nonabsorbed rifamycin for gastrointestinal disorders. Clin Infect Dis. 2006 Feb 15;42(4):541-7. Epub 2006 Jan 17. PMID: 16421799 DOI: 10.1086/499950
https://doi.org/10.1086/499950
33. Amaral JD, Viana RJ, Ramalho RM, Steer CJ, Rodrigues CM. Bile acids: regulation of apoptosis by ursodeoxycholic acid. J Lipid Res. 2009 Sep;50(9):1721-34. doi: 10.1194/jlr.R900011-JLR200. Epub 2009 May 5.
https://doi.org/10.1194/jlr.R900011-JLR200
34. Guarino MP, Cocca S, Altomare A, Emerenziani S, Cicala M. Ursodeoxycholic acid therapy in gallbladder disease, a story not yet completed. World J Gastroenterol. 2013 Aug 21;19(31):5029-34. doi: 10.3748/wjg.v19.i31.5029.
https://doi.org/10.3748/wjg.v19.i31.5029
35. Stein HJ, Kauler WK, Feussner H, Siewert JR. Bile acids as component of the duodenogastric refluate: detection, relationship to bilirubin, mechanism of injury, and clinical relevance. Hepatogastroenterology. 1999;46:66–73.
36. Kirk G, Kennedy R, McKie L, Diamond T, Clements B. Preoperative symptoms of irritable bowel syndrome predict poor outcome after laparoscopic cholecystectomy. Surg Endosc. 2011 Oct;25(10):3379-84. doi: 10.1007/s00464-011-1729-7. Epub 2011 May 10.
https://doi.org/10.1007/s00464-011-1729-7
37. Elmi F, Silverman WB. Biliary sphincter of Oddi dysfunction type I versus occult biliary microlithiasis in post-cholecystectomy patients: are they both part of the same clinical entity? Dig Dis Sci. 2010 Mar;55(3):842-6. doi: 10.1007/s10620-009-0788-2. Epub 2009 Apr 1.
https://doi.org/10.1007/s10620-009-0788-2
38. Guarino MPL, Cocca S, Altomare A, Emerenziani S, Cicala M. Ursodeoxycholic acid therapy in gallblader disease, a story not yet completed. World J Gastroenterol. 2013 Aug 21; 19(31): 5029–5034. doi: 10.3748/wjg.v19.i31.5029, PMCID: PMC3746374
https://doi.org/10.3748/wjg.v19.i31.5029