Clinical and functional state of the pancreas, liver, and intestinal microbiota in patients with chronic biliary-dependent pancreatitis after cholecystectomy

Abstract

The purpose of the study: To evaluate the clinical and functional state of the pancreas, liver and intestinal microbiota in patients with chronic biliary- dependent pancreatitis (CKD) after cholecystectomy.Materials and methods. 110 patients with CKD were examined, who were divided into 2 groups: group 1–58 patients (CKD) with a history of cholecystectomy. Group 2–52 patients with CKD with concomitant GI. The control group consisted of 35 practically healthy people. Patients with CKD with preserved gallbladder formed a comparison group with the main group. Cholecystectomy was performed according to urgent indications in most cases, but in some cases it was performed “prophylactically” with asymptomatic GI.All patients underwent:• ultrasound elastometry of the liver on the device “FibroScan” (“EchoSens”, France).• the study of the ability of cells to produce cytokines — TNF-a and TGF-b was determined by the enzyme immunoassay using test systems manufactured by the company “Cytokine” (St. Petersburg) and the company “R&D systems” (USA).• study of the concentration of pancreatic elastase-1 in feces by ELISA using test systems of the company “ScheBoBiotech” (Germany).• determination of the absolute and relative content of FGC (C2-C4) by gas-liquid chromatographic analysis in blood serum and faeces on the Crystal 2000 M chromatograph.Conclusion. In patients with CKD with a history of cholecystectomy, there are more significant violations of the metabolic activity of the intestinal microflora, lipid metabolism, liver fibrosis indicators, the severity of external secretory pancreatic insufficiency (VSN pancreas), which is accompanied by an increase in cytokine levels: TGF-b and TNF-a, an increase in the absolute content of short- chain fatty acids (FFA) in blood serum and feces and multidirectional changes in their spectrum, depending on the severity of the pancreatic VSN, the stage of liver steatosis, cholesterol levels compared with those of patients with CKD with preserved LC.