The effect of bile acid preparations on lipid metabolism in patients with postcholecystectomy syndrome

Authors: G. A. Anoknina, V. V. Kharchenko, P. L. Shupyk National Medical Academy оf Postgraduate Education of Health Ministry of Ukraine, Kyiv


Objective

To investigate the effects of the treatment with the preparation of ursodeoxycholic acid Choludexan on the blood lipid levels in patients with the postcholecystectomy syndrome (PCES).

Materials and methods

The investigation involved 46 patients with PCES and 21 healthy volunteers. The age of patients was 38 to 65 years; women prevailed among these patients: 35 (76.1 %). The examinations included general clinical investigations, body mass index, waist circumflex, esophagogastroduodenoscopy, abdomen ultrasonic examinations, multiphase duodenal intubation with the definition of the time of Oddi sphincter of opening, volume and rate of the choledochic bile portion excretion, bacteriologic investigation of the choledochic and hepatic bile portions. The blood lipid and glucose levels were measured, as well as the biochemical parameters of hepatic function. The patients were divided into two groups depending on the treatments: the main group (n = 23) and comparison group (n = 23). Patients of both groups were administered the individual diet with restriction of simple carbohydrates, fats and high protein proportion. The patients of main group were additionally administered Choludexan in a dose of 900 mg/day.

Results

At baseline, the dyslipidemia was revealed in patients with PCES. After the treatment, attenuation of the signs of sonographic liver steatosis was observed. The positive dynamics was more expressed in patients of the main group. In this group, the portion of patients with the dilatated bile duct decreased. Thus, the size of the bile duct of 8 — 10 mm was revealed only in 8.7 % of patients. After the treatment, the positive dynamics of blood lipid levels was observed in patients of the main group. In particular, the blood levels of the high density lipoprotein cholesterol significantly increased in patients of the main group (in 1.2 times, р < 0.01), whereas in patients of the comparison group, the trend toward the increase of this parameter was observed (the difference between these parameters before and after treatment wasn’t statistically significant).

Conclusions

The administration of the individual dietary treatment and ursodeoxycholic acid Choludexan preparation promoted the decrease of the sonographic signs of the liver steatosis, bile duct diameter, reduction of the blood levels of atherogenic lipids, and increase of the high density lipoprotein cholesterol levels.

Key words: postcholecystectomy syndrome, lipids, bile duct, Choludexan.

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