FEATURES OF DIAGNOSIS AND MINIMALLY INVASIVE CORRECTION OF CHOLEDOCHOLITHIASIS IN PATIENTS WITH METABOLIC SYNDROME

Authors

S.Sh. Musoev1 Sh.Sh. Amonov1 2 Z.Sh. Fayziev1 M.O. Olimi1 2
Job:

1Republican Scientific Center for Cardiovascular Surgery
2Department of Surgical Diseases No. 2 named after Academician N.U. Usmanov, State Educational Institution “Tajik State Medical University named after Avicenna,” Dushanbe, Tajikistan
 

DOI:
10.65197/3106-4035-2025-1-4-61-80

Annotation

Resume.

Goal.

The aim of the study was to improve diagnostic and the effectiveness of surgical treatment for choledocholithiasis (CL) in patients with metabolic syndrome (MS) using minimally invasive endoscopic methods.

Material and methods.

The study included 31 patients with choledocholithiasis associated with metabolic syndrome who underwent endoscopic interventions. Eightyone percent of the patients were workingage women who presented to the Republican Scientific Center for Cardiovascular Surgery between 2024 and 2025. Most of the patients had stage II and III obesity. Endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiostomy were used.

Results.

Endoscopic interventions demonstrated 100% diagnostic accuracy. Complications were reported in 5.5% of patients (minor bleeding after papillotomy), and acute pancreatitis developed in 19.3% of patients and was successfully treated conservatively. Early ERCP with EPST reduced the risk of complications. According to the developed algorithm, in cases with low AAR (conventionally designated as grade I) and predominantly associated pathologies, preference should be given to EPST and EPST with lithoextraction. If cholangitis is present, lithoextraction with nasobiliary drainage is necessary. In patients with moderate AAR (conventionally designated as grade II) and predominantly associated somatic pathologies, preference is also given to minimally invasive endoscopic interventions, such as EPST and EPST with leukoextraction.

Conclusion.

The developed treatment algorithm, considering the clinical features of the patient, proved effective. Endoscopic methods for treating choledocholithiasis are the optimal option for minimally invasive intervention, reducing surgical aggression and the risk of complications.

Keywords

Choledocholithiasis obstructive jaundice metabolic syndrome obesity endoscopic papillosphincterotomy ERCP

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List of literature

  1. 1. Абрамова А.Г., Хорев А.Н., Плюта А.В. Выбор оперативных вмешательств при лечении пациентов с крупным множественным холедохолитиазом. Современные проблемы науки и образования. 2016; 5: 100-109.
  2. 2. Агаев Б.А., Юсифзаде К.Р. Эффективность усовершенствованной методики сфинктеротомии при обструкции внепеченочных желчных путей. Вестник Российской военно-медицинской академии. 2015; 1: 23-28.
  3. 3. Кит О.И., Колесников Е.Н., Мезенцев С.С., Снежко А.В. Антеградные операции желчеотведения при механической желтухе. Анналы хирургической гепатологии. 2017; 22(2): 89-93. https://doi.org/10.16931/1995-5464.2017289-93.
  4. 4. Ходжамурадов Г.М., Шаймонов А.Х., Саидов М.С., Шамсов Н.Х., Мирзоев Н.М. Хирургия желудка и другие виды оперативных вмешательств при ожирении: сравнительная оценка результатов лечения. Евразийский научно-медицинский журнал «Сино». 2024; 5(1): 47-54. https://doi.org/10.54538/2707-5265-2024-5-1-47-54.
  5. 5. Махмадов Ф.И., Нажмудинов Ф.Н. Выбор миниинвазивной тактики лечения холедохолитиаза у больных с ожирением. Вестник последипломного образования в сфере здравоохранения. 2022; 2: 44-51.
  6. 6. Махмадов Ф.И., Садуллоев Д.Н., Муродов А.И., Ашуров А.С., Сафаров Ф.Ш., Нажмудинов Ф.Н. Релапаротомия и повторные миниинвазивные вмешательства в гепатобилиарной хирургии. Здравоохранение Таджикистана. 2022; 2(353): 54-59. https://doi.org/10.52888/0514-2515-2022-353-2-55-60.
  7. 7. Хаджибаев Ф.А., Тилемисов С.О., Хашимов М.А., Тилемисов Р.О. Антеградная и ретроградная холангиография при диагностике механической желтухи. Вестник хирургической гастроэнтерологии. 2016; 3: 76. https://doi.org/10.17116/vhge20163376.
  8. 8. Dasgupta A., Banerjee R., Pan T., Suman S., Basu U., Paul B. Metabolic syndrome and its correlates: A cross-sectional study among adults aged 18-49 years in an Urban Area of West Bengal. Indian Journal of Public Health. 2020; 64(1): 50-54. https://doi.org/10.4103/ijph.IJPH_50_19.
  9. 9. Wilkins T., Agabin E., Varghese J., Talukder A. Gallbladder dysfunction: cholecystitis, choledocholithiasis, cholangitis, and biliary dyskinesia. Primary Care: Clinics in Office Practice. 2017; 44(4): 575-597. https://doi.org/10.1016/j.pop.2017.07.002.
  10. 10. Хакимзода Б.Х., Рахмонов Д.А. Опыт проведения миниинвазивных вмешательств по поводу ожирения в условиях Республики Таджикистан. Пластическая хирургия и восстановительная медицина. 2025; 1(1): 6-15. https://doi.org/10.65197/3106-4035-2025-1-1-6-15.
  11. 11. Хакимзода Б.Х. Резекция желудка при морбидном ожирении: современное состояние вопроса. Евразийский научно-медицинский журнал «Сино». 2024; 5(2): 69-78. https://doi.org/10.54538/2707-5265-2024-5-2-69-78.
  12. 12. Галимов О.В., Ханов В.О., Насырова К.В., Галимов Д.О., Ибрагимов Т.Р. Способ прогнозирования результатов хирургического лечения морбидного ожирения при рестриктивном типе бариатрической операции. Медицинский вестник Башкортостана. 2025; 19(5): 59-63.
  13. 13. Salimbene O., Voltolini L., Mercier O., Viggiano D., Hanna A., Gonfiotti A., Fadel E. Parenchyma-Sparing Bronchial Sleeve Resection in Low-Grade Malignant Diseases. Cancers. 2025; 17(13): 2156.
  14. 14. Rusca Giménez M., Gonzalez-Rivas D., Gómez Tabales J., Bosinceanu M.L., Illana Wolf J., Espinosa Jiménez D. Uniportal Robotic-Assisted Sleeve Resection of the Left Main Bronchus and Secondary Carinal Reconstruction for Typical Carcinoid Tumor. European Journal of Cardio-Thoracic Surgery. 2025; 67(9): ezaf280.
  15. 15. Ruziev U.S. The effect of laparoscopic sleeve resection of gastric on nutritional status and the effectiveness of its correction (literature review). Central Asian Journal of Medicine. 2025; 3: 137-147.
Information
Language

English

License

CC BY 4.0

Category

MINIMALLY INVASIVE SURGERY

FINANCING

There was no financial support.

CONFLICT OF INTEREST

The authors declare no conflict of interest.

INFORMATION ABOUT THE AUTHORS:

*Musoev Sorbon Sheralievich – Candidate of Medical Sciences, Head of the Treatment and Diagnostic Department of the Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Tajikistan.
https://orcid.org/0000-0002-7178-5250 

E-mail: smusoev00@mail.ru
Amonov Shukhrat Shodievich – Doctor of Medical Sciences, Leading Researcher of the Department of Endoscopic Surgery of the Republican Scientific Center for Cardiovascular Surgery, Associate Professor of the Department of Surgical Diseases No. 2 named after Academician N. U. Usmanov, State Educational Institution “Tajik State Medical University named after Avicenna”, Dushanbe, Tajikistan.
https://orcid.org/0000-0002-3702- 6584
E-mail: shuhrat.amonov@yandex.ru
Fayziev Zakirjon Sharifovich – Candidate of Medical Sciences, Senior Researcher, Department of Endoscopic Surgery, Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Tajikistan.
https://orcid.org/0000-0003-4172- 4286
E-mail: zokir.67@mail.ru
Olimi Maruf Olimjon – applicant of the Department of Surgical Diseases No. 2 named after Academician N. U. Usmanov, State Educational Institution «Tajik State Medical University named after Abu Ali ibn Sino», research fellow in the Department of Bariatrics and Herniology of the Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Tajikistan.
https://orcid.org/0000-0002-1761- 0257
E-mail: marufjon93-93@mail.ru
 

*Correspondence address.