Functional morphology of the liver in extrahepatic cholestasis of non-tumor genesis.

Abstract

Background. To date, there is no data on the possibility of using elastography to assess the functional morphology of the liver in extrahepatic cholestasis (EHC) of non-tumor genesis. Objective. To determine the status of functional morphology of the liver in patients with different types of EHC of non-tumoral genesis in comparison with elastometry. Methods. The analysis is based on a preoperative examination of 121 patients with EHC of non-tumor genesis,treated at the Department of Digestion Surgery of the Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine from 2013 to 2019, which were divided into 4 groups depending on the presence of jaundice and hepatocytes damage. All patients underwent standard clinical trials, US, SWE D2. The presence of endogenous intoxication (EI) was determined by the content of medium molecular peptides (MMP). Intraoperative liver biopsy was performed in 65 patients with different types of EHC non-tumoral genesis: 17 patients with type 1, 14 patients with type 2, 15 type 3 and 19 patients with type 4. Results. Variants of progression of changes in functional morphology of the liver were determined in 4 types of EHC of non-tumoral genesis in comparison with elastometry data and biochemical studies. Conclusion. Functional morphology of the liver depends on the type of EHC of non-tumoral genesis, with the progression of inflammation, varying degrees of destruction of hepatocytes, proliferation and destruction of ducts with obstruction of bile ducts, fibrosis and cirrhosis of the liver. According to SWE, liver stiffness does not reflect the actual status of functional liver morphology in patients with non-tumor EHC, but may indicate its duration.

Keywords

• позапечінковий холестаз непухлинного генезу
• еластометрія
• маркери ендогенної інтоксикації
• біопсія печінки