actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problemsactabiomedica-842Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWS OF LITERATUREПАТОГЕНЕЗ И ЛЕЧЕНИЕ ХОЛЕСТЕРИНОВОГО ХОЛЕЦИСТОЛИТИАЗА (ОБЗОР)PATHOGENESIS AND TREATMENT OF CHOLESTEROL CHOLECYSTOLITHIASIS (REVIEW)ТюрюминЯ. Л.TuruminYA. L.drjacobturumin@yahoo.comШантуровВ. А.ShanturovV. A.noemail@neicon.ruТюрюминаЕ. Э.TuruminaE. E.noemail@neicon.ruФГБУ «Научый центр реконструктивной и восстановительной хирургии» СО РАМНScientific Center of Reconstructive and Restorative Surgery SB RAMS, IrkutskГБУЗ «Иркутская ордена «Знак почета» областная клиническая больница»Irkutsk Regional Clinical Hospital20122804201202(2)181186Copyright © Тюрюмин Я.Л., Шантуров В.А., Тюрюмина Е.Э., 20122012Тюрюмин Я.Л., Шантуров В.А., Тюрюмина Е.Э.Turumin Y.L., Shanturov V.A., Turumina E.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/842

Желчнокаменная болезнь и хронический калькулезный холецистит — самые распространенные заболевания в гастроэнтерологии, требующие хирургического лечения. С возрастом, количество больных желчнокаменной болезнью или. хроническим, калькулезным холециститом, постоянно увеличивается. Соответственно, растет, количество холецистэктомированных больных. Холестериновые и смешанные желчные камни в желчном, пузыре составляют, от. 60 до 80 %. В настоящее время холестериновый холецистолитиаз рассматривают, как комплекс метаболических нарушений в печени и желчном, пузыре. Механизм, формирования, холестериновых желчных камней объединяет, совокупность ряда условий: перенасыщение пузырной желчи холестерином и. преципитацию кристаллов моногидрата холестерина, гиперсекрецию гликопротеинового муцина и. гипомоторную дисфункцию желчного пузыря. Лечение желчнокаменной, болезни и. хронического калькулезного холецистита включает, обычную (открытую) и. лапароскопическую холецистэктомию, холецистолитотомию. Органосохраняющие методы, применяются только для лечения холестериновой, желчнокаменной, болезни: ударно-волновая литотрипсия, химический литолиз и. растворение холестериновых желчных камней с помощью приема желчных кислот. (ХДХК и. УДХК).

Gallstone disease and chronic calculous cholecystitis are the most prevalent gastroenterological diseases which require a surgical treatment. The quantity of patients with, gallstone disease or chronic calculous cholecystitis constantly is increased with, raise in age. Accordingly, the quantity of patients after cholecystectomy grows. The cholesterol gallstones and. mixed, gallstones in the gallbladder can make up from 60 % up to 80 %. Now cholesterol cholecystolithiasis is considered, as a complex of metabolic disorders in a liver and. a gallbladder. The mechanism of formation of cholesterol gallstones unites set of some conditions: cholesterol supersaturation of gallbladder bile and. precipitation, of cholesterol monohydrate crystals, hypersecretion, of glycoprotein, mucins and. gallbladder hypomotility. Treatment of gallstone disease and chronic calculous cholecystitis includes the ordinary opened, cholecystectomy and. laparoscopic cholecystectomy, sometimes cholecystolithotomy. Organ preservation, methods are applied only for the treatment of cholesterol gallstones: extracorporeal shock-wave lithotripsy of gallstones, local contact chemical litholysis with. MTBE and. systemic litholysis with, bile acids (CDCA and. UDCA).

желчный пузырьпеченьхолестеринжелчные кислотыхолестериновые желчные камниэнтерогепатическая циркуляцияхолестериновая желчнокаменная болезньхронический калькулезный холециститхолецистэктомияgallbladderlivercholesterolbile acidscholesterol gallstonesenterohepatic circulationcholesterol gallstone diseasechronic calculous cholecystitischolecystectomyReferencesЗубовский Г.А. Радиоизотопная и ультрасонографическая диагностика заболеваний желчевыводящей системы. — М.: Медицина, 1987. — 240 с.Зубовский Г.А. Радиоизотопная и ультрасонографическая диагностика заболеваний желчевыводящей системы. — М.: Медицина, 1987. — 240 с.Комаров Ф.И., Галкин В.А., Иванов А.И., Максимов В.А. Сочетанные заболевания органов дуоденохоледохопанкреатической зоны. — М.: Медицина, 1983. — 256 с.Комаров Ф.И., Галкин В.А., Иванов А.И., Максимов В.А. Сочетанные заболевания органов дуоденохоледохопанкреатической зоны. — М.: Медицина, 1983. — 256 с.Angelico M., Capocaccia L., Ricci G. Relationships between serum lipids and cholelithiasis: Observations in the GREPCO Study // Epidemiology of Gallstone Disease. — Lancaster: MTP Press, 1984. — P. 132 — 135.Angelico M., Capocaccia L., Ricci G. Relationships between serum lipids and cholelithiasis: Observations in the GREPCO Study // Epidemiology of Gallstone Disease. — Lancaster: MTP Press, 1984. — P. 132 — 135.Bilhartz L.E., Horton J.D., Feldman M., Schar-schmidt B.F. et al. Gallstone disease and its complications // Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. — 6th ed. — Philadelphia: WB Saunders Company, 1998 — P. 948 — 972.Bilhartz L.E., Horton J.D., Feldman M., Schar-schmidt B.F. et al. Gallstone disease and its complications // Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. — 6th ed. — Philadelphia: WB Saunders Company, 1998 — P. 948 — 972.Busch N., Lammert F., Matern S., Fromm H., Leuschner U.. Imbalance of biliary pronucleating and antinucleating factors in cholesterol gallstone formation // Bile Acids-Cholestasis-Gallstones. Advances in Basic and Clinical Bile Acid Research. — Dordrecht: Kluwer, 1996. — P. 194 — 202.Busch N., Lammert F., Matern S., Fromm H., Leuschner U.. Imbalance of biliary pronucleating and antinucleating factors in cholesterol gallstone formation // Bile Acids-Cholestasis-Gallstones. Advances in Basic and Clinical Bile Acid Research. — Dordrecht: Kluwer, 1996. — P. 194 — 202.Carey M.C., Duane W.C., Arias I.M., Boyer J.L. et al. Enterohepatic circulation // The Liver, Biology and Pathobiology. — 3rd ed. — New York: Raven Press, 1994. — P. 719 — 767.Carey M.C., Duane W.C., Arias I.M., Boyer J.L. et al. Enterohepatic circulation // The Liver, Biology and Pathobiology. — 3rd ed. — New York: Raven Press, 1994. — P. 719 — 767.Carey M.C., Fromm H., Leuschner U. Formation and growth of cholesterol gallstones: the new synthesis // Bile Acids-Cholestasis-Gallstones. Advances in Basic and Clinical Bile Acid Research. — Dordrecht: Kluwer, 1996. — P. 147—175.Carey M.C., Fromm H., Leuschner U. Formation and growth of cholesterol gallstones: the new synthesis // Bile Acids-Cholestasis-Gallstones. Advances in Basic and Clinical Bile Acid Research. — Dordrecht: Kluwer, 1996. — P. 147—175.Carey M.C., Gerok W., Loginov A.S., Pokrowskij V.I. Pathogenesis of cholesterol and pigment gallstones: some radical new concepts // New Trends in Hepatology 1996. — Dordrecht: Kluwer, 1996. — P. 64 — 83.Carey M.C., Gerok W., Loginov A.S., Pokrowskij V.I. Pathogenesis of cholesterol and pigment gallstones: some radical new concepts // New Trends in Hepatology 1996. — Dordrecht: Kluwer, 1996. — P. 64 — 83.Cooper A.D., Fromm H., Leuschner U. Plasma lipoprotein metabolism // Bile Acids-Cholestasis-Gallstones. Advances in Basic and Clinical Bile Acid Research. — Dordrecht: Kluwer, 1996. — P. 97—126.Cooper A.D., Fromm H., Leuschner U. Plasma lipoprotein metabolism // Bile Acids-Cholestasis-Gallstones. Advances in Basic and Clinical Bile Acid Research. — Dordrecht: Kluwer, 1996. — P. 97—126.Erlanger S., Arias I.M., Boyer J.L., Fausto N. et al. Bile flow // The Liver, Biology and Pathobiology. -3rd ed. - New York: Raven Press, 1994. - P. 769-786.Erlanger S., Arias I.M., Boyer J.L., Fausto N. et al. Bile flow // The Liver, Biology and Pathobiology. -3rd ed. - New York: Raven Press, 1994. - P. 769-786.Gentiliani P., Romanelli R.G., Foschi M., Mazzanti R., Surrenti C. Pathogenetic mechanism of intrahepatic cholestasis // Fat-storing Cells and Liver Fibrosis. - Dordrecht: Kluwer Academic Publishers, 1994. - P. 279-303.Gentiliani P., Romanelli R.G., Foschi M., Mazzanti R., Surrenti C. Pathogenetic mechanism of intrahepatic cholestasis // Fat-storing Cells and Liver Fibrosis. - Dordrecht: Kluwer Academic Publishers, 1994. - P. 279-303.Glickman R.M., Sabesin S.M., Arias I.M., Boyer J.L. et al. Lipoprotein metabolism // The Liver, Biology and Pathobiology - 3rd ed. - New York: Raven Press, 1994. - P. 391-414.Glickman R.M., Sabesin S.M., Arias I.M., Boyer J.L. et al. Lipoprotein metabolism // The Liver, Biology and Pathobiology - 3rd ed. - New York: Raven Press, 1994. - P. 391-414.Hellstern A., Leuschner U. Indications for topical dissolution therapy // Bile Acids-Cholestasis-Gallstones. Advances in Basic and Clinical Bile Acid Research - Dordrecht: Kluwer, 1996. - P. 228-235.Hellstern A., Leuschner U. Indications for topical dissolution therapy // Bile Acids-Cholestasis-Gallstones. Advances in Basic and Clinical Bile Acid Research - Dordrecht: Kluwer, 1996. - P. 228-235.Hofmann A.F., Arias I.M., Boyer J.L., Fausto N. et al. Bile Acids // The Liver, Biology and Pathobiology. - 3rd ed. - New York: Raven Press, 1994. -P. 677-718.Hofmann A.F., Arias I.M., Boyer J.L., Fausto N. et al. Bile Acids // The Liver, Biology and Pathobiology. - 3rd ed. - New York: Raven Press, 1994. -P. 677-718.Hofmann A.F., Feldman M., Scharschmidt B.F., Sleisenger M.H. Bile secretion and the enterohepatic circulation of bile acids // Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. - 6th ed. - Philadelphia: WB Saunders Company, 1998. - P. 937-948.Hofmann A.F., Feldman M., Scharschmidt B.F., Sleisenger M.H. Bile secretion and the enterohepatic circulation of bile acids // Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. - 6th ed. - Philadelphia: WB Saunders Company, 1998. - P. 937-948.Honda A., Yoshida T., Tanaka N. et al. Increased bile acid concentration in liver tissue with cholesterol gallstone disease // J. Gastroenterol. - 1995. - Vol. 30. - P. 61-66.Honda A., Yoshida T., Tanaka N. et al. Increased bile acid concentration in liver tissue with cholesterol gallstone disease // J. Gastroenterol. - 1995. - Vol. 30. - P. 61-66.Klueppelberg U.G., Molero X., Gaisano H.Y., Miller L.J., Swobodnik W. et al. Neurohormonal aspects of gallbladder contractility in gallstone disease: the role of cholecystokinin // Gallstone Disease: Pathophysiology and Therapeutic Approaches, H. Ditschuneit, R.D. Soloway. - Berlin: Springer-Verlag, 1990. - P. 67-86.Klueppelberg U.G., Molero X., Gaisano H.Y., Miller L.J., Swobodnik W. et al. Neurohormonal aspects of gallbladder contractility in gallstone disease: the role of cholecystokinin // Gallstone Disease: Pathophysiology and Therapeutic Approaches, H. Ditschuneit, R.D. Soloway. - Berlin: Springer-Verlag, 1990. - P. 67-86.Lehman G.A., Sherman S., Feldman M., Scharschmidt B.F. et al. Motility and dismotility of the biliary tract and sphincter of Oddi // Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. - 6th ed. - Philadelphia: WB Saunders Company, 1998. -P. 929-936.Lehman G.A., Sherman S., Feldman M., Scharschmidt B.F. et al. Motility and dismotility of the biliary tract and sphincter of Oddi // Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. - 6th ed. - Philadelphia: WB Saunders Company, 1998. -P. 929-936.Meier P.J. Regulation of bile acid carrier expression in normal and diseased liver // Bile Acids in Hepabiliary Diseases: Basic Research and Clinical Application / G. Paumgartner, A. Stiehl, W. Gerok. -Dordrecht: Kluwer Academic Publishers, 1997. -P. 95-103.Meier P.J. Regulation of bile acid carrier expression in normal and diseased liver // Bile Acids in Hepabiliary Diseases: Basic Research and Clinical Application / G. Paumgartner, A. Stiehl, W. Gerok. -Dordrecht: Kluwer Academic Publishers, 1997. -P. 95-103.Mulvihill S.J. Surgical management of gallstone disease and postoperative complications // Sleisenger and Fordtran's Gastrointestinal and Liver Сведения об авторах Disease: Pathophysiology, Diagnosis, Management / M. Feldman, B.F. Scharschmidt, M.H. Sleisenger. - 6th ed. - Philadelphia: WB Saunders Company, 1998. -P. 973-984.Mulvihill S.J. Surgical management of gallstone disease and postoperative complications // Sleisenger and Fordtran's Gastrointestinal and Liver Сведения об авторах Disease: Pathophysiology, Diagnosis, Management / M. Feldman, B.F. Scharschmidt, M.H. Sleisenger. - 6th ed. - Philadelphia: WB Saunders Company, 1998. -P. 973-984.Nilsell K. Biliary lipid metabolism in gallstone disease and during gallstone dissolution treatment. -Stockholm, Repro-Print AB, 1985. - 105 p.Nilsell K. Biliary lipid metabolism in gallstone disease and during gallstone dissolution treatment. -Stockholm, Repro-Print AB, 1985. - 105 p.Paumgartner G., Sackmann M., Holl J., Sau-erbruch T. Extracorporeal shock-wave lithotripsy of gallstones // Gallstone Disease: Pathophysiology and Therapeutic Approaches / W. Swobodnik, H. Ditschuneit, R.D. Soloway R.D. - Berlin: Springer-Verlag, 1990. - P. 161-164.Paumgartner G., Sackmann M., Holl J., Sau-erbruch T. Extracorporeal shock-wave lithotripsy of gallstones // Gallstone Disease: Pathophysiology and Therapeutic Approaches / W. Swobodnik, H. Ditschuneit, R.D. Soloway R.D. - Berlin: Springer-Verlag, 1990. - P. 161-164.Paumgartner G. Nonsurgical management of gallstone disease // Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management / M. Feldman, B.F. Scharschmidt, M.H. Sleisenger. - 6th ed. - Philadelphia: WB Saunders Company, 1998. - P. 984-993.Paumgartner G. Nonsurgical management of gallstone disease // Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management / M. Feldman, B.F. Scharschmidt, M.H. Sleisenger. - 6th ed. - Philadelphia: WB Saunders Company, 1998. - P. 984-993.Reichen J., Simon F.R. Cholestasis // The liver, Biology and Pathobiology / I.M. Arias, J.L. Boyer, N. Fausto et al. - 3rd ed. - New York: Raven Press, 1994. - P. 1291 -1326.Reichen J., Simon F.R. Cholestasis // The liver, Biology and Pathobiology / I.M. Arias, J.L. Boyer, N. Fausto et al. - 3rd ed. - New York: Raven Press, 1994. - P. 1291 -1326.Salvioli G., Lugli R., Pellati M. Nucleation and aggregation of cholesterol crystals in the early phase of gallstone genesis // Gallstone Disease: Pathophysiology and Therapeutic Approaches / W. Swobodnik, H. Ditschuneit, R.D. Soloway. - Berlin: Springer-Verlag, 1990. - P. 11-25.Salvioli G., Lugli R., Pellati M. Nucleation and aggregation of cholesterol crystals in the early phase of gallstone genesis // Gallstone Disease: Pathophysiology and Therapeutic Approaches / W. Swobodnik, H. Ditschuneit, R.D. Soloway. - Berlin: Springer-Verlag, 1990. - P. 11-25.Sherlock S., Dooley J. Diseases of the liver and biliary system. - 9th ed. - Oxford: Blackweel Scientific Publications, 1993. - 649 p.Sherlock S., Dooley J. Diseases of the liver and biliary system. - 9th ed. - Oxford: Blackweel Scientific Publications, 1993. - 649 p.Stiehl A., Swobodnik W., Ditschuneit H., Soloway R.D. Principles of gallstone dissolution with chenodeoxycholic acid, ursodeoxycholic acid, and the combination of both bile acids // Gallstone Disease: Pathophysiology and Therapeutic Approaches. - Berlin: Springer-Verlag, 1990. - P. 115-120.Stiehl A., Swobodnik W., Ditschuneit H., Soloway R.D. Principles of gallstone dissolution with chenodeoxycholic acid, ursodeoxycholic acid, and the combination of both bile acids // Gallstone Disease: Pathophysiology and Therapeutic Approaches. - Berlin: Springer-Verlag, 1990. - P. 115-120.Strasberg S.M., Soper N.J., Callery M.P., Fromm H. et al. Laparoscopic cholecystectomy - achievements and problems, 1995 // Bile Acids-Cholestasis-Gallstones. Advances in Basic and Clinical Bile Acid Research. - Dordrecht: Kluwer, 1996. -P. 236-250.Strasberg S.M., Soper N.J., Callery M.P., Fromm H. et al. Laparoscopic cholecystectomy - achievements and problems, 1995 // Bile Acids-Cholestasis-Gallstones. Advances in Basic and Clinical Bile Acid Research. - Dordrecht: Kluwer, 1996. -P. 236-250.Verkade H.J., Havinga R., Kuipers F., Vonk R.J., Hofmann A.F. et al. Mechanism of biliary lipid secretion // Bile Acids in Gastroenterology: Basic and Clinical Advances. - Dordrecht: Kluwer Academic Publishers, 1995. - P. 230-246.Verkade H.J., Havinga R., Kuipers F., Vonk R.J., Hofmann A.F. et al. Mechanism of biliary lipid secretion // Bile Acids in Gastroenterology: Basic and Clinical Advances. - Dordrecht: Kluwer Academic Publishers, 1995. - P. 230-246.Vlahcevic Z.R., Hylemon P.B., Chiang J.Y.L., Arias I.M. et al. Hepatic cholesterol metabolism // The Liver, Biology and Pathobiology. - 3rd ed. - New York: Raven Press, 1994. - P. 379-389.Vlahcevic Z.R., Hylemon P.B., Chiang J.Y.L., Arias I.M. et al. Hepatic cholesterol metabolism // The Liver, Biology and Pathobiology. - 3rd ed. - New York: Raven Press, 1994. - P. 379-389.

The authors declare that there are no conflicts of interest present.