Aim. To assess the condition of hepatopancreatobiliary system and quality of life in patients in the remote period after cholecystectomy.Methods. 88 patients with cholelithiasis who undergone cholecystectomy in 2008-2010 were examined 5 years after the surgery. Common blood count, blood biochemistry test were performed, fasting blood glucose level was measured, esophagogastroduodenoscopy, ultrasonic examination of abdominal organs, fractional duodenal intubation, fecal elastase test (ELISA, «BioServ Diagnostics», Germany) were performed. Patients filled out questionnaires to assess the quality of life: MOS SF-36 (Medical Outcomes Study Short Form), GIQLI (Gastrointestinal Quality of Life Index) before, 1 and 5 years after cholecystectomy.Results. According to the esophagogastroduodenoscopy, 56 (63.6%) patients had duodenal reflux, 21 (23.8%) - duodenal diverticula, 9 (10.2%) - reflux esophagitis. Reduced fecal pancreatic elastase-1 was detected in 37 (42%) of patients. According to the fractional duodenal intubation, hypersecretory type was the most prevalent, 40 (45.5%) patients had hypotonic sphincter of Oddi, 48 (54.5%) - hypertonic sphincter of Oddi. All patients had crystals of calcium bilirubinate, leukocytes and bacteria in bile, microliths were identified in 76 (86%) of patients. After emergency surgery, quality of life increased by all indicators, after planned cholecystectomy for asymptomatic cholelithiasis the quality of life decreased 1 and 5 years after cholecystectomy. After planned cholecystectomy for symptomatic cholelithiasis, the surgery improved quality of life, but after 5 years indicators for quality of life returned to preoperative levels.Conclusion. Various changes in hepatopancreatobiliary system organs are detected in patients after cholecystectomy, like disorders of bile formation and biliary excretion, sphincter of Oddi dysfunction, decreased function of the pancreas, which reduce the quality of life.
Objective: to assess the quality of life of patients and the state of the hepatopancreatobiliary system before and after cholecystectomy in the long-term period. Materials and methods: at the first stage, 107 people were examined after emergency, planned cholecystectomy (with symptomatic and asymptomatic course of GI). At the second stage, 90 people at different times after cholecystectomy for a more detailed examination of the external secretory function of the pancreas was performed. Results: the majority of patients, regardless of the type of surgery, had symptoms of dyspepsia associated with the development of functional disorders of the gastrointestinal tract (gastroesophageal reflux, duodenogastric reflux, sphincter Oddi dysfunction). A decrease in the external secretory function of the pancreas was shown regardless of the period after cholecystectomy. Conclusion: after cholecystectomy, functional disorders of the digestive system predominate in the long-term period due to loss of the physiological function of the gallbladder.
The article presents a rare clinical case of Gaucher's disease, a hereditary disease that belongs to lysosomal accumulation diseases. A 36-year-old patient was admitted to the clinic with complaints of pain in the left half of the abdomen, pain in the chest, cough with yellow sputum, difficulty breathing due to pain, general weakness. The mental underdevelopment, hepatosplenomegaly, anemia, thrombocytopenia, and the threat of rupture of the spleen were revealed in the process of collecting anamnesis and examination. The patient was transferred to the surgical department, and a splenectomy was performed. Histological examination of the spleen and genetic examination confirmed the diagnosis of Gaucher's disease.
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