THERAPEUTIC APPLICATION OF PLASMAPHERESIS IN SURGICAL MANAGEMENT OF ACUTE BENIGN CHOLANGITIS

Аннотация

This research evaluates the therapeutic efficacy of plasmapheresis (PF) integrated into the surgical treatment protocol for acute benign cholangitis. The study encompassed 17 patients who underwent a novel therapeutic approach combining plasmapheresis with indirect electrochemical detoxification, utilizing sodium hypochlorite solution and ozonation for autoplasma recovery. The implementation of plasmapheresis, alongside comprehensive pharmacological intervention, demonstrated significant clinical efficacy in patients presenting with cholangitis complicated by hepatic insufficiency. Notable improvements in endotoxemia parameters and hepatic function were observed within 48-72 hours post-intervention. Specifically, aspartate aminotransferase (AsAT) levels decreased from 1.4±0.05 to 0.5±0.02 mmol/l, while alanine aminotransferase (AlAT) reduced from 1.1±0.06 to 0.37±0.01 mmol/l. The incorporation of plasmapheresis with antihypoxant and antioxidant therapy yielded substantial reductions in oxidative stress markers and endotoxemia parameters. By day 4, diene conjugates (DC) decreased to 1.3±0.03 opt.pg/ml, malondialdehyde (MDA) levels reduced to 3.2±0.21 mmol/mg, and blood lactate concentrations diminished to 2.4±0.6 mmol, indicating significant improvement in the patients' metabolic status. These findings suggest that plasmapheresis, when integrated into a comprehensive treatment protocol, represents an effective therapeutic modality for managing acute benign cholangitis, particularly in cases complicated by hepatic dysfunction and endotoxemia.