The optimization of treatment of patients with obstructive jaundice

Abstract

Background. In abdominal surgery, there is a great interest in patients with obstructive jaundice, which is due to the preservation of a high incidence rate and an insufficient degree of satisfaction with the results of treatment. One of the ways to improve the results of treatment is to search for optimal schemes for correcting homeostasis disorders, especially its most important component – endogenous intoxication. The purpose of the workis to optimize the course of the early postoperative period of patients with obstructive jaundice of non-tumor origin of moderate severity (class B). Materials and methods. A survey of 58 patients with mild obstructive jaundice of moderate severity (class B) who underwent various surgical interventions aimed at restoring the passage of bile into the duodenum was conducted. In the first group (n = 28), standard therapy was performed in the early postoperative period, in the second (n = 30), it included remaxol. The diagnostic complex includes: indicators of the clinical course of the disease, assessment of the syndrome of endogenous intoxication by the content of toxic products of hydrophilic and hydrophobic nature in the blood; indicators of the functional state of the liver. Results. The use of remaxol in the complex therapy of patients with mechanical jaundice of non-tumor origin leads to a significant reduction in homeostasis disorders, which resulted in a decrease in hydrophilic and hydrophobic toxins in the blood. With this kind of therapy, the clinical course of the disease was optimized: the number of postoperative complications significantly decreased (according to the Clavien-Dindo classification from 57.1 % in the first group to 20.0 % in the second group (χ2 = 3.853, p = 0.050), the duration of hospital stay of patients was reduced by 2.7 bed days (p < 0.05). Conclusions. The inclusion of the hepatoprotector remaxol in the complex therapy of patients with obstructive jaundice leads to a decrease in the severity of endogenous intoxication syndrome, optimizes the course of the early postoperative period.

Keywords

• obstructive jaundice
• endogenous intoxication
• remaxol
• complications
• homeostasis