SIGNIFICANCE OF OCTAPEPTIDE CHOLECYSTOKININ IN DEVELOPMENT OF ODDI’S SPHINCTER DYSFUNCTION OF INORGANIC ETIOLOGY AFTER CHOLECYSTECTOMY IN PATIENTS OPERATED FOR CALCULOUS CHOLECYSTITIS

Abstract

Aim. To improve the results of treatment of patients with cholelithiasis, calculous cholecystitis and Oddi’s sphincter dysfunction of inorganic etiology. Materials and methods. 214 patients of both sex (aged 25–80) with acute calculous cholecystitis (ACC) and postcholecystectomy syndrome (PCES) were examined. All patients were divided into 4 groups depending on the scheme of treatment carried out. Results. Cholecystokinin level determined in patients with cholelithiasis makes it possible to assess the severity of functional biliary disorders. Cholecystokinin concentration <0,5 ng/ml with absence of organic pathology from the side of the organs of hepatopancreatoduodenal zone indicates Oddi’s sphincter dysfunction of functional nature. In case of a two-fold decrease in cholecystokinin level on the day 9 th after cholecytectomy, the probability of development of Oddi’s sphincter dysfunction of functional nature is increased by 22,6% that requires administration of selective spasmolytic drugs. Conclusion. The developed scheme of complex therapy allows to eliminate manifestations of postcholecystectomy syndrome of functional etiology at earlier terms compared to patients cured with traditional conservative therapy.