Experience of treatment of acute cholangitis with the use of anti-bacterial photodynamic therapy

Abstract

Introduction. Acute cholangitis is a life-threatening disease characterized by an ascending inflammatory and infectious process in the biliary tree. Biliary decompression and systemic or local antibiotic therapy are key points in the treatment of acute cholangitis, regardless of the etiology of the disease. At the same time, an evergrowing antibacterial resistance requires the search for new ones, including non-pharmacological methods of combating infectious agents, one of which is photodynamic therapy. The aim of the work is to assess the effectiveness of the use of antibacterial photodynamic therapy in the complex treatment of acute cholangitis. Materials and methods. The paper presents the experience of using antibacterial photodynamic therapy in the complex treatment of acute cholangitis in 7 patients with obstructive jaundice. Standard methods of percutaneous transhepatic cholangiosis and conservative treatment of acute cholangitis were supplemented by intraductal antibacterial photodynamic therapy according to the technique developed by the authors. Photolon (Belmedpreparaty, Republic of Belarus) was used as a photosensitizer. The radiation was supplied through a quartz-polymer fiber with a diameter of 400 μm. The radiation wavelength is λ = 660 nm, the radiation power is 50 mW. The exposure time is 5–7 minutes. Results. The bactericidal effect of antibacterial photodynamic therapy was established, expressed in a statistically significant decrease in microbial contamination in bile already on the 3rd day of the study with its complete eradication on the 6th day of the study (p < 0.05). The average treatment time for acute cholangitis was 11.2 ± 2.4 days. Findings. Thus, the use of bile duct drainage in combination with intraductal antibacterial photodynamic therapy allows to stop the cholangitis phenomenon, reduce the economic costs of treatment, as well as the subsequent rehabilitation of this category of patients.