The effect of bile decompression on pro- and antioxidant markers in the complications of gallstones associated with cholestatic jaundice

Abstract

JAUNDICE (Abstract) : Argumentation of optimal terms for a staged surgical approach in the benign complications of gallstones associated with cholestatic jaundice by assessing the effect of biliary decompression on pro- and antioxidant markers. Material and methods: Prospective study, selected 105 patients with complicated gallstones and associated cholestatic jaundice, divided into three homogeneous subgroups, dependent on evolutionary com-plication. Control group - 35 patients with uncomplicated gallstones. All patients in the study group followed the staged treatment protocol in obstructive jaundice, with the primary prerogative - internal biliary decompression by endoscopic papillosphincterotomy. Pro- and antioxidant markers were assessed at hospitalization, on the 1st and 4th day after decompression. Results: Malonic dialdehyde at hospitalization marked in all subgroups with statistically significant results compared to the control group: I - 12.11±0.64 mol/l [p<0.001 (t=10.7)], II - 11.12±0.53mol/l [p<0.001 (t=10.9)]; III - 13.16±0.44 mol/l [p<0.001 (t=16.5)]. The activity of the antioxidant system evaluated by superoxide dismutase values [p<0.001(t=6.4); (t=4.1); (t=5.7)] and catalase [p<0.001(t=6.7); (t=5.6); (t=7.6)] shows a decrease in all subgroups compared to the control group. On the 1st day after drainage, malonic dialdehyde values did not show statistical significance compared to the before decompression state [I -p>0.05 (t=0.11); II - p>0.05 (t=0.91)]. An obvious reduction of its activity was found on the 4th after decompression day [I - p<0.001 (t=5.15; II - p<0.01 (t=2.6); III - p<0.001 (t =3.99)]. The return of the antioxidant system in all subgroups to values relatively similar to the control group: superoxide dismutase [I - p<0.05 (t=2.21); II - p<0.05 (t=0.0008); III -p<0.05 (t=0.33)] and catalase [I - p<0.05 (t=2.39); II - p<0.05 (t=3.52); III - p<0.01 (t=2.87)] was found more than 4 days after decompression. Conclusions: The study demonstrated the positive influence of biliary decompression in the complications of gallstones associated with cholestatic jaundice for the reduction of a massive lipid oxidation and the creation of conditions for increasing the antioxidant capacity with the restoration of the body's biological balance, which is more pronounced 4-5 days after decompression, serving as criterion for the possibility of definitive resolution of gallstones in these terms. OXIDATIVE STRESS, ANTIOXIDANT SYSTEM.