POSTCHOLECYSTECTOMY SYNDROME CAUSED BY VARIOUS DISORDERS OF INTESTINAL PERMEABILITY

Aim. This study was designed to prove the connection between postcholecystectomy syndrome, chronic disorder of duodenal patency, adhesive disease of the abdominal cavity, and chronic colostasis and to develop the methods of its treatment.

Materials and methods. During the period from 2004 to 2016 we monitored 140 patients with a clear picture of postcholecystectomy syndrome which was manifested after the surgeries on the extrahepatic biliary tract by clinic of passage disorders in the digestive tract.

Results. The results of our study indicate that there are created a number of conditions that cause various pathologies in patients with colostasis who have unfavorable outcomes after cholecystectomy. Colostasis can cause functional changes in the biliary tract due to the overstretch of the colon areas by the accumulated contents. Functional disturbances can be a consequence of the tension of the mesocolon lowered by the transverse colon or duodenojejunal ligament narrowing the lumen of the duodenum. The hepatic angle of the large intestine in high position, deforming the bile duct and duodenum, can also cause postcholecystectomy syndrome.

Conclusion. Long-term results of the surgical treatment of the pathological conditions after cholecystectomy depend not only on the condition of the organ which surgery was performed on but also on other physiologically related organs and body systems. The biliary and enteroenteric connections are very important in this case. Psychosomatic disorders of the patient are also crucial while assessing the long-term results of the surgical treatment of this type of patients. The results of the surgical treatment of the duodenal patency chronic disorders depend on the selected type of surgery. Thus, the exclusion of the duodenum from the food passage gives better results than the surgeries aimed at improving the passage of food through the duodenum. The choledochojejunostomy and duodenoenterostomy are not effective. In the most severe cases of duodenal patency chronic disorders two sided exclusion of the duodenum with duodenenterostomy can be the only effective method of its correction but the development of post-resection syndrome cannot be ruled out.