Fes'kov V. Prognosis of multiple organ failure in surgical treatment of mechanical jaundice of benign etiology.

Study object: mechanical jaundice of benign etiology. Study aim: improvement of results of medical treatment of obturation cholestasis of benign etiology. Study methods: clinical, biochemical, immunological, bacteriological methods, doppler ultrasound of vessels of abdominal cavity, upper endoscopy, endoscopic retrograde cholangiopancreatography (ERCP) and intraoperative cholangiography. Practical value of the got results: prognostic significant criteria in relation to development of multiple organ failure were defined. Depending on risk of development of multiple organ failure optimized surgical tactics. Scientific novelty of the got results: new pathogenic mechanisms of development of complications of mechanical jaundice are exposed. It is found that mechanical jaundice depending on duration and form of clinical manifestation is accompanied by the changes of circulation of blood in hepatosplanchnic area. It is proved that the condition of hepatosplanchnic hemodynamics is important part of pathogenesis of complications of mechanical jaundice. It was found that immunity of patients with a mechanical jaundice without organ or system failure differs by the preserved indexes of cellular and humoral immunity on a background of suppressed phagocyte activity of neutrophills. In majority of patients with purulent cholangitis secondary combined structural-functional immunodeficiency of cellular and humoral types with disturbances of phagocyte activity of neutrophills occurred. However, there were patients immune answer of which was characterized by activating of cellular and humoral immunity, and neutrophills. Similar immune reactions were observed in patients with multiple organ failure due to acute purulent cholangitis, however the depth of immune disturbances in this group of patients was larger. Degree of introduction: Study results are applied and used in practice of surgical departments of 18th city clinical hospital, Regional clinical hospital of Kharkiv, Institute of General and Urgent Ssurgery of АМS of Ukraine. Sphere (region) of the use: medicine, surgery