Sostoyanie posle kholetsistektomii: khirurg, terapevt, patsient. Otchet ekspertnogo soveta po voprosam postkholetsistektomicheskikh rasstroystv


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Abstract

Cholecystectomy is one of the most common surgical procedures performed in Russia and worldwide. Following this procedure, complaints for pain and dyspepsia are presented by at least in half of patients. Postcholecystectomy syndrome (PCS) is multifactorial in its nature with both organic, i.e., structural, and functional causes underlying its pathogenesis. About half of cases of pain and dyspepsia after cholecystectomy are associated with organic diseases (stenosed distal ductus choledochus, pancreatic and gastric cancer, acute pancreatitis, etc.), while the remaining cases are caused by functional disorders, including sphincter of Oddi dysfunction. Diarrhea occurring in patients after gallbladder removal is also associated with functional gut motility disorders. Mebeverine was demonstrated to relieve pain and dyspepsia in several uncontrolled pilot studies in patients with biliary pathology. The Working Group on PCS set up among the authors of this paper addressed current aspects of the syndrome and discussed importance of the clinical trial on the effects Duspatalin® (mebeverine) on gastrointestinal spasms and pains following cholecystectomy.

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