Preoperative method of assessment of gallbladder lesion in acute cholecystitis
https://doi.org/10.29413/ABS.2022-7.3.25
Abstract
Background. To date acute cholecystitis remains one of the most common urgent abdominal diseases in which postoperative complications and mortality are possible.
The aim. To assess the correlation of gamma-glutamyltranspeptidase and alkaline phosphatase concentrations in blood plasma with the form of acute cholecystitis.
Methods. A study of 105 patients with acute calculous cholecystitis, 35 – with chronic calculous cholecystitis (comparison group), who underwent laparoscopic cholecystectomy, was performed. At admission to the hospital, the activity of gammaglutamyltranspeptidase (GGTP) and alkaline phosphatase in blood plasma was determined by kinetic colorimetric method.
Results. A direct correlation was revealed between the level of GGTP concentration and the severity of destruction in the gallbladder wall. With catarrhal cholecystitis, it was 340 ± 116.9 U/l (p < 0.05), with phlegmonous – 108.1 ± 29.5 U/l (p < 0.05), with gangrenous – 32.9 ± 7.5 U/l (p < 0.05). Along with this, a direct correlation was revealed between the concentration of alkaline phosphatase and the severity of destruction in the gallbladder wall. In catarrhal cholecystitis, the enzyme activity was 160.3 ± 34.2 U/l (p < 0.05), in phlegmonous – 129.9 ± 14.6 U/l (p < 0.05), in gangrenous – 57 ± 18.5 U/l (p < 0.05).
Conclusion. Determination of the concentration of GGTP and alkaline phosphatase in combination with other diagnostic criteria makes it possible to determine the presence of destructive forms of acute cholecystitis with high specificity and sensitivity before surgery.
About the Authors
A. A. YashnovRussian Federation
Cand. Sc. (Med.), Teaching Assistant at the Department of Intermediate Level Surgery with a Course of Urology
Gorkogo str. 39А, Chita 672000, Russian Federation
S. L. Lobanov
Russian Federation
Dr. Sc. (Med.), Professor, Head of the Department of Intermediate Level Surgery with a Course of Urology
Gorkogo str. 39А, Chita 672000, Russian Federation
O. G. Konovalova
Russian Federation
Cand. Sc. (Med.), Docent, Associate Professor at the Department of Intermediate Level Surgery with a Course of Urology
Gorkogo str. 39А, Chita 672000, Russian Federation
M. A. Burtseva
Russian Federation
Postgraduate at the Department of Intermediate Level Surgery with a Course of Urology
Gorkogo str. 39А, Chita 672000, Russian Federation
Yu. S. Hanina
Russian Federation
Cand. Sc. (Med.), Docent, Associate Professor at the Department of Intermediate Level Surgery with a Course of Urology
Gorkogo str. 39А, Chita 672000, Russian Federation
References
1. Agapchev AV. Methods for predicting processes in medicine. Intellektual’nye tekhnologii i sredstva reabilitatsii i abilitatsii lyudey s ogranichennymi vozmozhnostyami (ITSR-2017): Materialy II Vserossiyskaoy konferentsii. 2018: 105-106. (In Russ.).
2. Ukhanov AP, Charchyan GL, Novozhilov EV, Bolshakov SV, Zakharov DV. Comparative analysis of the results of using endovideosurgical and traditional cholecystectomy in patients with acute destructive cholecystitis in different age groups. Endovideokhirurgiya v usloviyakh mnogoprofil’nogo statsionara: Materialy mezhdunarodnoy nauchno-prakticheskoy konferentsii. 2014: 142-144. (In Russ.).
3. Norov AKh, Rakhmatullaev RR, Kurbonov DM, Rakhmatullaev AR, Khasanov SV. Features of laparoscopic cholecystectomy in elderly and senile patients suffering from acute cholecystitis. Endovideokhirurgiya v usloviyakh mnogoprofil’nogo statsionara: Materialy mezhdunarodnoy nauchno-prakticheskoy konferentsii. 2014: 80-84. (In Russ.).
4. Revishvili ASh, Olovyannyi VE, Sazhin VP, Zakharova MA, Kuznetsov AV, Mironova NL, et al. Surgical Care in the Russian Federation. Moscow; 2020. (In Russ.).
5. Yokoe M, Hata J, Takada T, Strasberrg S, Asbum H, Wakabayashi G, et al. Tokyo guidelines 2018 diagnostic criteria and severity grading of acute cholecystitis. J Hepatobiliary Pancreat Sci. 2018; 25(1): 41-54. doi: 10.1002/jhbp.515
6. Buriev IM, Melkonyan GG, Malyuga NS, Pchelin VV, Shomakhov MG. Ultrasound and clinical and laboratory diagnostics of true morphological forms of acute cholecystitis: the need to change the classification. Annals of HPB Surgery. 2020; 25(3): 55-62. (In Russ.). doi: 10.16931/1995-5464.2020355-62
7. Zikriyarova NT, Mulat ST, Zakirov ZK, Yusupov DU, Kumarbekov TM, Li GV. Artificial intelligence is a promising area of medicine: mathematical methods of pattern recognition in relation to the problems of diagnostics, prediction and classification in the field of surgery. Global Science and Innovations: General Asia. 2021; 2(12): 42-47. (In Russ.).
8. Lutsevich OE. Acute cholecystitis: possibilities of laparoscopic surgery. Annals of HPB Surgery. 2020; 25(3): 63-70. (In Russ.). doi: 10.16931/1995-5464.2020363-70
9. Davlatov SS, Zhuraeva FF, Yusupalieva KB. The effectiveness of minimally invasive methods of surgical treatment of patients with acute destructive cholecystitis. Academy. 2017; 7(22): 92-94. (In Russ.).
10. Davlatov SS, Askarov PA. Results of treatment of patients with bile leakage after cholecystectomy. Molodoy organizator zdravookhraneniya: Sbornik nauchnykh statey studentov.2013: 68. (In Russ.).
11. Rakhmanov KE, Kurbaniyazov ZB, Akbarov MM, Davlatov SS. The treatment of patients with major bile duct injuries. Akademicheskiy zhurnal Zapadnoy Sibiri. 2013; 9(1): 33-34. (In Russ.).
12. Davlatov SS, Kasymov ShZ, Kurbaniyazov ZB, Rakhmanov KE, Ismailov AO. Plasmopheresis in the treatment of cholemic endotoxicosis. Akademicheskiy zhurnal Zapadnoy Sibiri. 2013; 9(1): 30-31. (In Russ.).
13. Yaroslavtsev MI, Pakhomov MA, Morozov AM. Features of the diagnosis of acute cholecystitis in various patients. Forcipe. 2020; 3(S1): 87-95. (In Russ.).
14. Dolgov VV, Menshikov VV. Clinical laboratory diagnostics: National guidelines. Moscow: GEOTAR-Media; 2013. (In Russ.).
15. Mudrov VA. Algorithms for statistical analysis of qualitative features in biomedical research using the SPSS software package. The Transbaikalian Medical Bulletin. 2020; 1: 151-163. (In Russ.). doi: 10.52485/19986173_2020_1_151
Review
For citations:
Yashnov A.A., Lobanov S.L., Konovalova O.G., Burtseva M.A., Hanina Yu.S. Preoperative method of assessment of gallbladder lesion in acute cholecystitis. Acta Biomedica Scientifica. 2022;7(3):253-259. (In Russ.) https://doi.org/10.29413/ABS.2022-7.3.25