Object - bile peritonitis; objective - improve the results of treatment of patients with bile peritonitis by means of developing pathogenically substantiated methods of diagnostics, differentiated treatment depending on the form of peritonitis, surgical or conservative treatment, prevention of complications; methods - histological, histochemical, optic, microbiological, clinical statistical; results - a comprehensive comparative assessment of the parameters of the renal function, sodium ions transport, acid-regulating function, glomerular-tubular and tubular-tubular balance under conditions of uninfected and infected bile peritonitis; the development of the latter is found to differ by deeper pathological changes, occurrence of sodium ions "loss" syndrome, proteinuria against the ground of reduced titrating acid secretion, and ammonia with urea, a comparative histochemical examination of the kidney and liver tissues is performed, infected bile peritonitis is found to differ from uninfected one by statistically significant increase of protein oxidative modification by R/B coefficient (р<0,001), which is a sign of occurrence of the antioxidant protection mechanisms failure, a comparative examination of the venous blood plasma optic density was performed, under conditions of infected bile peritonitis contrary to uninfected one the parameters of the index were found to increase significant statistically (р<0,05) over 0,58 units on the wave length of?=280 nm, in case of infected bile peritonitis than those of non-infected one, changes of the dispersal zone distance of the laser beam by the peritoneum have been examined, the source of the laser beam is a laser diode radiating at the wave length of ?=0,63 mcm, in case of non-infected bile peritonitis the parameters of this index were found to grow statistically significant in 1,5-2 times (р<0,05), and in case of infected bile peritonitis they increase more than twice, a comparative examination of bile microflora in patients with various forms of bile peritonitis has been performed for the first time in clinical conditions, the amount of anaerobic an aerobic bacteria in bile increased statistically in case of infected peritonitis, at the same time, in case of non-infected peritonitis the content of Candida genus prevailed, a comparative examination of the colon microbe content has been carried out, in case of non-infected bile peritonitis dysbiotic changes are found to occur, and dysbacteriosis develops with infected peritonitis, a comprehensive assessment of the immune system and synthesis activity of cytokines belonging to different classes has been made, functional ability of the immune mechanisms was found to be inhibited, and their latent insufficiency with manifestation of immune dissociation syndrome develop against the ground of the immune system activation under conditions of both forms of bile peritonitis in patients with infected bile peritonitis, a new method to diagnose acute cholecystitis has been applied including the measurement of luminescent intensity of the venous blood plasma on the wave range of ?=473 - 470 nm and detection of the index peak values enabling to increase the accuracy of diagnostics to 96%, a new method to diagnose bile peritonitis has been applied including the measurement of the venous blood plasma optic density on the wave range of ?=280 nm enabling to increase the diagnostic accuracy to 88%, a new devise and method of external drainage of the hepatic-jejunum anastomosis have been elaborated and applied enabling to prevent the development of suture failure, stricture of anastomosis, external intestinal fistulae, a new devise and method of the prolonged sanitation of the abdominal cavity have been elaborated and applied in case of infected bile peritonitis, according to the data of a comprehensive clinical-laboratory investigation their application enables to make the terms of inflammatory process regression in the abdominal cavity 1,4 times down, on the basis of the data obtained the diagnostic algorithm in case of bile peritonitis has been elaborated and scientifically substantiated enabling to choose an adequate therapeutic tactics involving a differentiated choice of the therapeutic measures at all the stages of treatment depending on the form of peritonitis.
