Основные аспекты терапии начальных стадий желчнокаменной болезни. Нужны ли поиски «золотого» стандарта сегодня?

Abstract

Over the past decades, there has been a clear trend towards an increase in the number of patients suffering from cholelithiasis, especially among persons of working age. At the same time, the early phase of the disease (biliary sludge), which commonly proceeds without clinical symptoms, acquires the greatest relevance. Besides, the cholelithiasis course can also be accompanied by biliary dyskinesia, which accelerates the process of calculus formation. That is why preventive conservative treatment allows most patients to avoid lithiasis at the early phase of cholelithiasis. And there is no gold standard of the treatment tactics for patient management at this phase. Some patients diagnosed with phase 1 cholelithiasis remain without therapy and monitoring. An oral litholytic therapy with ursodeoxycholic acid (UDCA) is proposed in some cases. This article draws increasing attention to the modern method for the treatment in the early phase of cholelithiasis, demonstrating a clinical example of a successful integrated treatment approach for a patient with biliary sludge, biliary dyskinesia and overweight. This method is aimed at correcting various pathogenetic factors of biliary sludge and reckons for the prescription of not only the UDCA drug but also a prokinetic. KEYWORDS: biliary sludge, biliary tract disorder, ursodeoxycholic acid, trimebutine, prevention, obesity, prokinetics. FOR CITATION: Pakhomova I.G. Main therapy aspects of the cholelithiasis early phase. Do we need to search for the gold standard nowadays? Russian Medical Inquiry. 2023;7(5):332–336 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-12.