Keywords
gastroduodenal ulcer
cholelithiasis (gallstone disease)
How to Cite
Abstract
In press
Background. In patients with cholelithiasis, undiagnosed erosive and ulcerative lesions of the gastroduodenal area in the perioperative period are dangerous due to the risk of complications such as gastroduodenal bleeding or ulcer perforation, which significantly worsens the prognosis for the treatment of the underlying disease.
Aim. The aim of the study was to evaluate the feasibility of using fibroesophagogastroduodenoscopy in patients with cholelithiasis to adequately adapt the treatment strategy for each individual patient.
Materials and Methods. An analysis of the examination and treatment results of 157 patients with cholelithiasis, in whom ulcerative and erosive lesions of the gastric and duodenal mucosa were diagnosed by esophagogastroduodenoscopy, was performed. Patients were divided into clinical subgroups depending on the clinical form of cholelithiasis. Statistical analysis was performed using Excel 2021 (Microsoft, USA) and SPSS Statistics 29 (IBM, USA) with the chi-square test and Fisher's exact test. The study is a fragment of the planned research work of the Department of Surgical Diseases of V.N. Karazin Kharkiv National University (state registration number 0124U003337).
Research Ethics. The study was conducted in accordance with the Declaration of Helsinki of the World Medical Association (1964–2024) and national ethical rules. All patients signed informed consent for treatment and participation in the scientific study.
Results. Among the examined patients, erosions of the gastroduodenal area were detected in 86 (54.78%) patients, ulcers – in 27 (17.20%) in the active phase, in 20 (12.74%) – in the healing phase, and in 16 (10.19%) – in the phase of epithelialization and scar formation. The use of standard four-component anti-ulcer therapy (omeprazole, bismuth tripotassium dicitrate, clarithromycin, metronidazole) for 14 days made it possible to avoid postoperative complications (acute gastroduodenal bleeding and ulcer perforation) in all patients of the study group.
Conclusions. Before surgery in patients with cholelithiasis, fibroesophagogastroduodenoscopy should be performed for timely detection of erosive and ulcerative lesions of the gastroduodenal area (including those with a latent course) and administration of adequate anti-ulcer therapy. Early treatment prevents the development of severe postoperative complications – acute gastroduodenal bleeding and perforations.
Keywords: surgery, gastroduodenal ulcer, cholelithiasis (gallstone disease).
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