Hepatic encephalopathy in patients with obstructive jaundice in the perioperative period

Introduction. Gallstone disease is highly prevalent in developed countries. This disease can lead to life-threatening complications such as obstructive jaundice, liver-kidney failure, and hepatic encephalopathy. Diagnosing, preventing, and treating hepatic encephalopathy is crucial, especially in the postoperative period. There are several theories regarding the development of this complication. A combination of diagnostic methods is used to identify it. The treatment uses agents aimed at reducing hyperammonemia, increasing the neutralization of ammonia in the liver, reducing inhibitory processes in the central nervous system, and hepatoprotectors. After a drainage operation on the bile ducts, in the postoperative period, the drug Succinic acid was used. This drug has a membrane-stabilizing, cytoprotective effect and improves the energy supply of cells. The aim of the study is to improve the results of treatment of patients with benign obstructive jaundice in the postoperative period after drainage operations.

Materials and methods of research. The first group of the study included patients who administered 400 ml of the studied drug in the postoperative period. The second group received 800 ml. Early diagnosis of hepatic encephalopathy and monitoring of the dynamics of the patients' mental state were carried out using the number connection test. The results were recorded in both groups on days 1, 3, 5, 8, and at the end of the study (days 12–16). The reliability of the obtained data was determined using the Mann-Whitney U-test.

Results. The assessment of the time required to complete the neurophysiological test of number association showed a decrease of 17 seconds in patients of the second group.

Conclusion. Patients who received a double dose of succinic acid in the postoperative period showed the best results in the neurophysiological test.

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