The risk factors for development and demonstration of an acute cholangitis in patients, suffering benign obstruction of extrahepatic biliary ducts

Keywords: acute cholangitis; the risk factors; signs; obstruction of biliary ducts

Abstract

Objective. Determination of factors, promoting development of an acute cholangitis (ACH) or constituting its signs in benign obstruction of extrahepatic biliary ducts (EHBD).

Materials and methods. Retrospectively 144 observations of benign obstruction of extrahepatic biliary ducts, ACH was noted in 17 observations. Comparison of prevalence of various factors and signs in the patients with ACH and without it was accomplished.

Results. The difference was statistically proven (p < 0.05) between such indices: hyperthermy, Charcot’s triad, leucocytosis, content of stab neutrophils, level of general bilirubin, the blood amylase activity, the gallbladder wall thickness, presence of excluded gallbladder, fixated calculus of duodenal papilla magna (DPM), dimensions of DPM. The differences were absent (p > 0.05) between following indices: gender, age, BMI, presence of abdominal pain syndrome, cholecystectomy in anamnesis, the gallbladder volume, cause of obstruction, dilation of hepaticocholedochus, endoscopic papillosphincterotomy in anamnesis, presence of peripapillary diverticulum and an acute biliary pancreatitis.

Conclusion. The risk factors for development of ACH were: a general bilirubin level 70 mcmol/l and higher, the gallbladder wall thickening up to 4 mm and more, the excluded gallbladder, fixated calculus of DPM, dimension of DPM 15 mm and more. Signs of an ACH were: hyperthermy, presence of Charcot’s triad, leucocytosis 9 × 109 in 1 l and higher, enhancement of content of stab neutrophils up to 7% and higher, hyperamylasemia.

Author Biographies

I. N. Mamontov, Kharkov Medical Academy of Postgraduate Education, Kharkov, Ukraine

Mamontov Ivan Mikolayovich, MD, PhD (Med), Assistant professor,
department of surgery and proctology,
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197, Ukraine;
tel: +38 (057) 7601166;
е-mail: ivan.n.mamontov@gmail.com;
ORCID ID: 0000-0003-0059-2715

T. I. Tamm, Kharkov Medical Academy of Postgraduate Education, Kharkov, Ukraine

Tamm Tamara Ivanivna, MD, DSci(Med), professor,
Chief of department surgery and proctology,
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197, Ukraine;
tel: +38 (057) 7601166;
е-mail: tamm_ti@ukr.net;
ORCID ID: 0000-0001-6372-2092

K. A. Kramarenko, Kharkov Medical Academy of Postgraduate Education, Kharkov, Ukraine

Kramarenko Kostantin Olexandrovich, MD, PhD(Med), Assistant professor
department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197, Ukraine;
tel: +38 (057) 7601166;
е-mail: kakram1966@gmail.com;
ORCID ID: 0000-0002-1997-8928

S. G. Belov, Kharkov Medical Academy of Postgraduate Education, Kharkov, Ukraine

Belov Serhii Grigorovich, MD, DSci(Med), Professor
department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197, Ukraine;
tel: +38 (057) 7601166;
е-mail: byelov2304@ukr.net;
ORCID ID: 0000-0003-3956-2636

A. Ya. Bardyuk, Kharkov Medical Academy of Postgraduate Education, Kharkov, Ukraine

Bardiuk Olexandr Yakovlevich, MD, PhD (Med), Assistant professor
department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197, Ukraine;
tel: +38 (057) 7601166;
е-mail: alexjb709@ukr.net;
ORCID ID: 0000-0002-0069-030X

A. P. Zakharchuk, Kharkov Medical Academy of Postgraduate Education, Kharkov, Ukraine

Zakharchuk Oleksandr Petrovich, MD, PhD (Med), Assistant professor
department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197, Ukraine;
tel: +38 (057) 7601166;
е-mail: dokzakhar@gmail.com;
ORCID ID: 0000-0002-9023-9650

V. V. Nepomnyashchiy, Kharkov Medical Academy of Postgraduate Education, Kharkov, Ukraine

Nepomniashchyi Valentin Volodimirovich, MD, PhD (Med), Assistant professor
department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197, Ukraine;
tel: +38 (057) 7601166;
е-mail: doktor.nep@gmail.com;
ORCID ID: 0000-0001-6262-6795

E. A. Shakalova, Kharkov Medical Academy of Postgraduate Education, Kharkov, Ukraine

Shakalova Olena Anatolievna, MD, PhD (Med), Assistant professor
department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197, Ukraine;
tel: +38 (057) 7601166;
е-mail: shakalova.helena@gmail.com;
ORCID ID: 0000-0003-3401-4278

O. M. Reshetnyak, Kharkov Medical Academy of Postgraduate Education, Kharkov, Ukraine

Reshetniak Olga Mykhailovna, MD, PhD (Med), Assistant professor
department of surgery and proctology
Kharkiv Medical Academy of Postgraduate Education,
61037, Kharkiv, pr. Moskovsky, 197, Ukraine;
tel: +38 (057) 7601166;
е-mail: metide@ukr.net;
ORCID ID: 0000-0002-3290-6021

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Published
2019-09-28
How to Cite
Mamontov, I. N., Tamm, T. I., Kramarenko, K. A., Belov, S. G., Bardyuk, A. Y., Zakharchuk, A. P., Nepomnyashchiy, V. V., Shakalova, E. A., & Reshetnyak, O. M. (2019). The risk factors for development and demonstration of an acute cholangitis in patients, suffering benign obstruction of extrahepatic biliary ducts. Klinicheskaia Khirurgiia, 86(9), 32-37. https://doi.org/10.26779/2522-1396.2019.09.32
Section
General Problems of Surgery