GALLBLADDER WALL CONDITION IN THE LONG-TERM AFTER ENDOSCOPIC TRANSPAPILLARY INTERVENTIONS

Abstract

The aim of research. Study changes in the gallbladder wall in the long-term (more than 7days) after endoscopic transpapillary interventions on the common bile duct.Material and methods. Preparations of the 29 gallbladder wall, operatively removedmore than 7 days after endoscopic transpapillary interventions on the common bile ductwere painted with hematoxylin-eosin and pyrofuksin by Van Gison, the thickness ofmechanically strong structures (muscle layers, collagen) and mechanically weakstructures (intermediate edema, areas of necrosis, areas of leukocyte infiltration) of thegallbladder wall.Results. In terms more than 7 days after endoscopic transpapillary surgical interventionthe following types of changes in the gallbladder wall: "infiltrative sclerotic" and"restorative" were revealed. Basically, collagen structures and leukocyte infiltration havebeen detected in the period from 7 to 18 days following endoscopic transpapillaryintervention on the common bile duct in the gallbladder wall and distant surroundingtissues on the serous membrane side, that indicates strong adhesions with surroundingstructures against a background of pronounced inflammatory response in the area of thecystic duct and cystic artery ("infiltrative sclerotic" type). After 18 days followingendoscopic transpapillary interventions on the common bile duct signs of restoration ofthe structure of the gall bladder wall ("restorative" type of changes in the wall of the gallbladder) are observed.Conclusions. Standard therapy in preparation for the second stage of surgical treatmentof acute cholangitis in some cases does not restore the gallbladder wall and its strength,which is associated with varying degrees of inflammation, necrosis, atrophy, sclerosis ofthe gallbladder wall after endoscopic transpapillary intervention, as well as individualboth regenerative and immune capabilities. Changes in the gallbladder wall can bedescribed as changes in the "infiltrative sclerotic" and "restorative" types.