Endothelial dysfunction in postoperative purulent-septic complications of hepatobiliary zone pathologies

Abstract

Objective. Determination of the significance of endothelial dysfunction in postoperative purulent-septic complications of pathologies of the hepatobiliary zone.Material and methods. An analysis was conducted on 57 patients who underwent surgery for pathologies of the hepatobiliary zone and subsequently developed postoperative purulent-septic complications. Among these, there were 17 cases of postoperative peritonitis, 20 cases of postoperative intra-abdominal abscesses, and 20 cases of postoperative pancreatic necrosis. Of the patients, 19 were men (33.3%), and 38 were women (66.7%). Their ages ranged from 20 to 71 years.Results. Out of the 57 patients, when classified based on the severity of endotoxemia: 26.3% had a mild degree, another 26.3% had a moderate degree, 15% had a severe degree, and 21.0% had an extremely severe degree. High levels of oxidative stress markers and decreased SOD levels were particularly evident in patients with postoperative intra-abdominal abscesses. Furthermore, even greater acceleration of lipid peroxidation processes was observed in patients with severe endotoxemia resulting from widespread postoperative peritonitis and extensive to nearly total postoperative pancreatic necrosis. Additionally, significant changes were noted in endotoxemia predictors in portal blood, endothelial dysfunction markers, and cytokines in patients with postoperative intra-abdominal purulent-septic complications.Conclusion. Endothelial dysfunction in patients with postoperative purulent-septic complications is associated with profound pathomorphological changes in hepatocytes. These changes are evident in alterations to rheology, microcirculation, and increased levels of endothelial dysfunction markers.