Possible predictors of recurrent choledocholithiasis in patients with obesity
Abstract
Purpose of the study. To study possible predictors contributing to the recurrence of choledocholithiasis in obese patients.
Materials and methods of research. The study is based on 116 patients with choledocholithiasis, against the background of obesity of varying degrees. There were 38 (32.8%) patients with abdominal obesity of the 1st degree, 57 (49.1%) of the 2nd degree, 14 (12.1%) of the 3rd degree and 7 (6,0%) of the 4th degree of patients. According to the performed methods of operations, the patients were divided into 2 groups: the 1st main group consisted of 60 (51.7%) patients who underwent combined minimally invasive interventions and the 2nd, control group 56 (48.3%) patients who underwent emergency traditional intervention.
Research results and discussion. Analysis of the factors leading to choledocholithiasis recurrence in 11 (18.3%) patients of the main group with recurrent CL showed that preoperative leukocytosis, laparotomic method of the primary operation, drainage of the choledochus with a T-shaped drainage, a long stay in the hospital and a long period of time during operations were significantly associated with the development of recurrence. Another important predictor of choledocholithiasis recurrence in obese patients was the method of primary surgery on the gallbladder and bile ducts.
Conclusion. The recurrence of choledocholithiasis in patients with obesity, along with wellknown factors, is associated with such predictors as the picture of leukocytosis before the primary operation, the methods of surgery performed, and the size of the calculus.
About the Authors
F. I. Makhmadzoda
State Educational Institution “Tajik State Medical University named after. Abuali ibni Sino”
Tajikistan
Tajikistan
Mahmadzoda Farukh Isroil - MD, Professor of the Department of Surgical Diseases No. 1.
Tel.: (+992) 900 75 44 90
F. N. Najmudinov
State Educational Institution “Tajik State Medical University named after. Abuali ibni Sino”
Tajikistan
Tajikistan
Department of Surgical Diseases No. 1
References
1. Антонюк О.С., Шаповалов И.Н., Ярощак С.В. и др. Лапароскопическая лазерная холедохолитотрипсия. Вестник неотложной и восстановительной хирургии.2019;1(4):8-10.
2. Беспалова И.Д., Рязанцева Н.В., Калюжин В.В., Дзюман А.Н. и др. Клинико-морфологические параллели при абдоминальном ожирении. Бюллетень СО РАМН.2014;4(34):51-58.
3. Махмадов Ф.И., Каримов П.Ш., Мирбегиев Дж. Результаты лапароскопической холецистэктомии у больных с высоким операционным риском. Вестник Авиценны. 2019;1(21):121-128.
4. Махмадов Ф.И., Махмадёров Х.Ш., Мирбегиев Дж. Улучшение результатов острого билиарного панкреатита. Здравоохранение Таджикистана.2018;4(339):25-30.
5. Шаповалов И.Н., Голубицкий К.О., Антонюк О.С. и др. Сравнительный анализ традиционных и малоинвазивных методик лечения холедохолитиаза. Университетская клиника.2019;4(33):8-10.
6. Li ZQ, Sun JX, Li B, Dai XQ, Yu AX, Li ZF. Meta-analysis of singlestage versus twostaged management for concomitant gallstones and common bile duct stones. J Minim Access Surg 2020;16:206-214.
7. Singh AN, Kilambi R. Single-stage laparoscopic common bile duct exploration and cholecystectomy versus two-stage endoscopic stone extraction followed by laparoscopic cholecystectomy for patients with gallbladder stones with common bile duct stones: systematic review and meta-analysis of randomized trials with trial sequential analysis. Surg Endosc 2018;32:3763-3776.
8. Schacher FC, Giongo SM, Teixeira FJ, Mattos ÂZ. Endoscopic retrograde cholangiopancreatography versus surgery for choledocholithiasis: a meta-analysis. Ann Hepatol 2019;18:595-600.
9. Gantois D, Goudard Y, Bourgouin S, Pauleau G, de La Villéon B, Balandraud P. One-stage laparoscopic procedure versus twostage procedure in the management of common bile duct stones in patients aged 75 and more. J Visc Surg 2020;157:99-106.
10. Yoo ES, Yoo BM, Kim JH, et al. Evaluation of risk factors for recurrent primary common bile duct stone in patients with cholecystectomy. Scand J Gastroenterol 2018;53:466-470.
11. Parra-Membrives P, Martínez-Baena D, Lorente-Herce JM, JiménezRiera G, SánchezGálvez MÁ. Choledocholithiasis recurrence following laparoscopic common bile duct exploration. Cir Esp 2019;97:336342.
12. Al-Temimi MH, Kim EG, Chandrasekaran B, et al. Laparoscopic common bile duct exploration versus endoscopic retrograde cholangiopancreatography for choledocholithiasis found at time of laparoscopic cholecystectomy: analysis of a large integrated health care system database. Am J Surg 2017;214:10751079.
13. Gomez D, Cabrera LF, Villarreal R, et al. Laparoscopic common bile duct exploration with primary closure after failed endoscopic retrograde cholangiopancreatography without intraoperative cholangiography: a case series from a referral center in Bogota, Colombia. J Laparoendosc Adv Surg Tech A 2020;30:267272.
Review
For citations:
Makhmadzoda F.I., Najmudinov F.N. Possible predictors of recurrent choledocholithiasis in patients with obesity. Herald of the medical and social institute of Tajikistan. 2024;(4):41-49. (In Russ.)
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