Biliary slage as a stage of gallstone disease: the successes and difficulties of treatment
https://doi.org/10.21518/2079-701X2020-21-110-116
Abstract
Introduction. The high prevalence rates of biliary sludge and its frequent development into the stone stage of cholelithiasis constitute grounds for studying this issue, as the effective action on biliary sludge can prevent overall disease progression.
Purpose of the study. To determine the options for diagnosis of biliary sludge in the polyclinic settings. Objectives: 1) Estimate the frequency of diagnosis of biliary sludge. 2) Assess the features and dependence of treatment on the type of biliary sludge. 3) Assess the outcome of treatment depending on the follow-up managing of patients. 4) Propose an algorithm for managing patients after biliary sludge has been diagnosed.
Materials and methods. In the work used data of the clinics of the President of the Russian Federation. The total number of people surveyed for 1 year was 1.117. These patients underwent an ultrasound examination (dispensation) and 218 were fitted with biliary sludge (BS), which was 19.4%. Of the 70 patients with BS, 4 groups were formed: 1st group (20 patients) with BS type, 2nd (20 patients) – with BS type, 3rd (20 patients) – with BS type, 4th (10 patients) – with BS-type (BSS) type.
All patients received Exchhol therapy at the rate of 15 mg/kg of weight; patients with a pronounced spastic component in the sphincter system – myotropic spasmolytic Sparex (20 mg x 2 times a day); patients of the 4th group (with a near-located sediment indicating the presence of inflammation) – Adisord (derived nitrofuran) 200 mg x 4 times a day (5 days).
Results. The type of precipitation was cupped in 4 weeks of treatment; Type – for 8–12 weeks of treatment, type V – for 13–14 weeks.
Conclusions. The presented data allow us to hope that early diagnosis of biliary sludge and the factors of its development will help start timely treatment and prevention of the disease.
About the Authors
O. N. Minushkin
Central State Medical Academy
Russian Federation
Russian Federation
Dr. of Sci. (Med.), Professor, Head of Department of Gastroenterology,
19, Bldg. 1a, Marshal Timoshenko St., Moscow, 121359
T. B. Topchiy
Central State Medical Academy
Russian Federation
Russian Federation
Cand. of Sci. (Med.), Associate Professor, Department of Gastroenterology,
19, Bldg. 1a, Marshal Timoshenko St., Moscow, 121359
E. G. Burdina
Polyclinic No. 3 of the Administrative Department of the President of the Russian Federation
Russian Federation
Russian Federation
Dr. of Sci. (Med.), Head of Department of Gastroenterology,
31, Grokhol’skiy Lane, Moscow, 129090
E. V. Novozhenova
Polyclinic No. 1 of the Administrative Department of the President of the Russian Federation
Russian Federation
Russian Federation
Cand. of Sci. (Med.), General Practitioner, Prevention Room,
26/28, Sivtsev Vrazhek Lane, Moscow, 119002
Yu. E. Tugova
United Hospital and Polyclinic of the Administrative Department of the President of the Russian Federation
Russian Federation
Russian Federation
Cand. of Sci. (Med.), Head of Diagnostic and Treatment Department, Polyclinic,
6, Bldg. 15, Michurinskiy Ave., Moscow, 119285
References
1. Ilchenko A.A. Diseases of the gallbladder and biliary tree. Moscow; 2006. 78 p. (In Russ.)
2. Minushkin O.N., Burdina E.G., Novozhenova E.V. Biliary sludge: solved and unresolved issues. Meditsinskiy sovet = Medical Council. 2018;(14):90–96. (In Russ.) doi: 10.21518/2079-701X-2018-14-90-96.
3. Blyum H.E., Gerok V. Krankheiten der Leber und des biliaren Systems.
4. Il’chenko A.A. Diseases of the gallbladder and biliary tree. Moscow; 2011. (In Russ.) Режим доступа: http://kingmed.info/knigi/Gastroenterologiya/book_2768/Bolezni_jelchnogo_puzirya_i_jelchnih_putey_2-e_izdanieIlchenko_AA-2011-djvu.
5. Minushkin O.N. Hepatoprotectors (choice of a drug, duration of treatment, assessment of efficacy). Moscow; 2014. 21 p. (In Russ.)
6. Minushkin O.N., Burdina E.G., Novozhonova E.V., Vasilchenko S.A., Gurova N.Yu. Biliary sludge: diagnosis and treatment at an outpatients clinic. Ehksperimental'naya i klinicheskaya gastroehnterologiya = Experimental and Clinical Gastroenterology. 2013;(9):14–20. (In Russ.) Available at: https://elibrary.ru/item.asp?id=21440309.
7. Mayev I.V., Dicheva D.T., Buragina T.A. Diagnostics and treatment of biliary sludge in patients with peptic ulcer. Rossiyskiy zhurnal gastroehnterologii, gepatologii, koloproktologii = Russian Journal of Gastroenterology, Hepatology, Сoloproctology. 2007;17(4):68–72. (In Russ.) Available at: http://old-gastroj.ru/files/s12_1306315275.pdf.
8. Yakovenko E.P., Agafonova N.A., Yakovenko A.V., Ivanov A.N., Soluyanova I.P., Rusheva T.B. Modern approaches to treatment of patients with biliary sludge: how to choose optimal scheme? Meditsinskiy alfavit = Medical Alphabet. 2019;1(6):5–12. (In Russ.) doi: 10.33667/2078-5631-2019-1-6(381)-5-12.
9. Minushkin O.N., Elizavetina G.A., Ivanova O.I., Shaposhnikova O.F. Ursodeoxycholic acid in the treatment of patients with biliary sludge. Ehffektivnaya farmakoterapiya = Effective Drug Therapy. 2012;(25):10–13. (In Russ.) Available at: https://elibrary.ru/item.asp?id=21752551.
Review
For citations:
Minushkin ON, Topchiy TB, Burdina EG, Novozhenova EV, Tugova YE. Biliary slage as a stage of gallstone disease: the successes and difficulties of treatment. Meditsinskiy sovet = Medical Council. 2020;(21):110-116. (In Russ.) https://doi.org/10.21518/2079-701X2020-21-110-116
Views:
617
Email this article 