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EFFECTIVENESS OF DEKASAN IN THE TREATMENT OF PATIENTS
WITH CHOLEDOCHOLITHIASIS AND PURULENT CHOLANGITIS
Batirov D.Yu.
Rakhimov A.P.
Yusupov D.D.
Rustamov M.A.
Tashkent Medical Academy, Urgench Branch
https://doi.org/10.5281/zenodo.14869488
Relevance of the Topic:
The incidence of gallstone disease (GD) worldwide has been steadily
increasing in recent years [1]. Accordingly, choledocholithiasis, which is the
most common complication of GD, is also frequently observed [5]. It often
presents asymptomatically or without jaundice, while in 15%-47.8% of cases, it
is accompanied by purulent cholangitis and jaundice [2,4].
Currently, laparoscopic cholecystectomy is the main treatment for GD and
its complications. Additionally, various endoscopic procedures are widely used
to restore bile duct patency, including endoscopic papillotomy, endoscopic bile
duct sanitation and drainage, endoscopic papillosphincteroplasty, balloon
dilation, stenting, and others[3]. However, choosing the appropriate treatment
method, strategy, and timing for choledocholithiasis and purulent cholangitis
remains challenging, particularly in elderly patients and those with
comorbidities that significantly increase surgical risks. Therefore, improving
treatment outcomes remains a high priority[4].
Objective of the Study:
To improve the surgical treatment outcomes of patients with gallstone
disease and its complications, including choledocholithiasis and purulent
cholangitis.
Methods and Materials:
A retrospective analysis was conducted on 114 patients diagnosed with GD,
choledocholithiasis, and purulent cholangitis who underwent surgical treatment
at the surgical departments of the Khorezm Regional Multidisciplinary Medical
Center from 2012 to 2024. Among them, 54 patients (47.37%) were assigned to
the main group, while 60 patients (52.63%) formed the control group.
In the main group, laparoscopic cholecystectomy was performed, followed
by choledochoscopy through the cystic duct, where bile duct sanitation and
stone removal were carried out. The bile ducts were then flushed with a 0.2
mg/mL Dekasan solution heated to 38-40°C. Postoperatively, the bile duct was
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continuously irrigated with the same solution via a drainage tube (using the
Pikovsky method) for 7-21 days. In the control group (n=60), the same surgical
procedure was performed, but the bile ducts were flushed with conventional
antiseptic solutions (chlorhexidine, furacilin) and irrigated postoperatively for
8-35 days.
Results:
The postoperative results were as follows:
- Elevated div temperature in the postoperative period was observed in 8
patients (7.02%) in the main group and in 17 patients (14.91%) in the control
group.
- The duration of bile duct drainage varied between 7 to 21 days in the main
group, while in the control group, some patients required drainage for up to 35
days.
- The average hospital stay in the main group was 5.8+0.27 days, whereas in the
control group, it was 7.2+0.31 days.
- Other postoperative outcomes were nearly identical in both groups.
Conclusion:
Flushing the bile ducts with a 0.2 mg/mL Dekasan solution heated to 38-
40°C significantly improves treatment outcomes in patients with gallstone
disease complicated by choledocholithiasis and purulent cholangitis.
Literature:
1.
Aimagambetov M.Zh., Abdrakhmanov S.T. Results of Improving Diagnosis
and Optimizing Surgical Treatment of Acute Destructive Calculous Cholecystitis
in Patients with Overweight and Obesity. // Science and Healthcare, 2020, Issue
5 (Vol. 22), pp. 100-110.
2.
Nazyrov F.G., Akbarov M.M., Saidazimov E.M., Nishanov M.Sh. Errors and
Dangers in Biliary Surgery (A Guide for Doctors). // Surgery of Uzbekistan, No. 3,
2020, pp. 58-60.
3.
Samsonov A.A., Plotnikova E.Yu., Ruban A.P., Bagmet A.D., Ulyankina E.V.,
Evdokimova A.I. Gallstone Disease, Cholecystectomy – What’s Next? // Medical
Council, No. 4, 2014, pp. 50-54.
4.
Khadjibayev A.M., Khadjibayev F.A., Pulatov M.M., Shukurov B.I.,
Sobitkhanov M.S. The Role of Endobiliary Interventions in the Treatment of Bile
Leakage After Cholecystectomy. // Bulletin of Emergency Medicine, 2019, Vol.
12, No. 6, pp. 5-10.
5.
Ismailov U.S., Batirov D.Y., Raximov A.P. The Role Of rs1799883
Polymorphism Of The FABP2 Gene In The Pathogenesis Of Nosological Syntropy
Of Gallstone Disease And Metabolic Syndrome The American Journal of Medical
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International scientific-online conference
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Sciences and Pharmaceutical Research (ISSN – 2689-1026) Published: June 18,
2021 | Pages: 46-51 Doi:
https://doi.org/10.37547/TAJMSPR/Volume03Issue06-07
