Kytsai K. Clinical and pathogenetic aspects of chronic biliary pancreatitis combined with obesity, differenciated approaches to it treatment

Theoretical generalization and new scientific solution of the problem is presented in the thesis, i.e. increasing the effectiveness of treatment of the patients with chronic biliary pancreatitis combined with obesity, on the basis of evaluation of the main clinical and pathogenetic aspects and mechanisms of development of trophological insufficiency, as well as development of differentiated complex treatment programs, which consist of the use of metadoxine and the surface multi-needle differently-metal application course. The influence of biliary factors (functional disorders of the biliary system, chronic cholecystitis, laparotomic and minimally invasive cholecystectomy in the anamnesis) on the formation of exocrine pancreatic disorders, trophological disorders (protein, lipid, vitamin metabolism, anemic syndrome) and life quality in the patients with chronic pancreatitis combined with obesity was established. The effectiveness of differentiated treatment programs for correction of the revealed disorders by inclusion of the hepatoprotective medication metadoxin and the surface multi-needle differently-metal application course on the basis of improvement of the main clinical syndromes, life quality, structural status of the liver and the pancreas, trophological status indicators, correction of imbalance of the oxidant-antioxidant system, disorders of the kallikrein-kinin system and endotoxicosis was suggested, evaluated and proved. A new way of the functional capacity assessment of the pancreas was developed by calculating the total coprogram expressed in points. Mathematic formulas for prediction of the quantitative point of pancreatic stiffness was worked out for the first time and based on the consideration of clinical, anamnestic and laboratory parameters.