Clinical and experimental substantiation of the method the biliary debit manometry

Authors

  • Николай Николаевич Велигоцкий Kharkov Medical Academy of Postgraduate Education 58 Korchagintsev str., Kharkiv, Ukraine, 61176
  • Николай Николаевич Скалий Kharkov Medical Academy of Postgraduate Education. 58 Korchagintsev str., Kharkiv, Ukraine, 61176
  • Александр Викторович Горбулич Kharkov Medical Academy of Postgraduate Education 58 Korchagintsev str., Kharkiv, Ukraine, 61176
  • Сергей Эдуардович Арутюнов Kharkov Medical Academy of Postgraduate Education 58 Korchagintsev str., Kharkiv, Ukraine, 61176
  • Станислав Артурович Павличенко Kharkov Medical Academy of Postgraduate Education 58 Korchagintsev str., Kharkiv, Ukraine, 61176
  • Александр Александрович Лермонтов Kharkiv National Medical University 4 Lenina ave., Kharkiv, Ukraine, 61022

DOI:

https://doi.org/10.15587/2313-8416.2015.50323

Keywords:

biliary debit manometry, experimental substantiation, modeling

Abstract

Introduction. In spite of the permanent improvement of the diagnostic methods of causes of biliary obstruction it has not 100 % sensitivity and specificity and received data can be erroneous and difficult for clinical interpretation.

Substantiation. To assess at the modern scientific and technical level the functional state of patency of terminal section of choledoch using modified method of debit manometry that consists in registration of the volume of liquid injected into bile-excreting and the pressure in it.

Materials and methods of research. At elaboration of methods at the first stage it was carried out numerical modeling on the base of physical model of bile-excreting system with assessment of the levels of pressure in bile-excreting ducts at liquid injection, assessment of form of the curve of pressure changes and factors that influence on form and parameters of curve. At the second stage it was carried out an experimental assessment of correspondence of these models to the real data received in department of morbid anatomy. And at the last clinical stage it was carried out diagnostics of disorders of patency of bile-excreting system with following assessment of diagnostic and practical value of this method.

Results. The data received in experiment and modeling allowed to interpret the results of debit manometry received at examination of patients on the next algorithm: at the first stage it was assessed the type of curve: bell-shaped – disorder of outflow is absent but at the fast evacuation the disorders of consistency of sphincteral apparatus cannot be excluded, tooth-shaped – indicates the disorder of outflow of bile what can be caused by both organic and functional reasons, horizontal type – indicates the strict obstruction usually of organic character. At the second one it were assessed the quantitative indicators, the high level of pressure at the bolus introduction testified to the bile-excreting ways (BEW) obstruction, the low one – to an inconsistency of sphincteral apparatus.

Conclusions. The numerical experimental data allowed establish regularities of bile-excreting system functioning from the positions of hydrodynamics. Verification of these data in conditions of controlled experiment on the real bile-excreting ducts allowed confirm these conclusions and specify the features of hemodynamics in conditions of dissected sphincteral apparatus

Author Biographies

Николай Николаевич Велигоцкий, Kharkov Medical Academy of Postgraduate Education 58 Korchagintsev str., Kharkiv, Ukraine, 61176

MD, Professor

Head of Department of Thoracoabdominal Surgery

Николай Николаевич Скалий, Kharkov Medical Academy of Postgraduate Education. 58 Korchagintsev str., Kharkiv, Ukraine, 61176

Graduate student

Department of Thoracoabdominal Surgery

Александр Викторович Горбулич, Kharkov Medical Academy of Postgraduate Education 58 Korchagintsev str., Kharkiv, Ukraine, 61176

Candidate of Medical Sciences, Associate Professor

Department of Thoracoabdominal Surgery

Сергей Эдуардович Арутюнов, Kharkov Medical Academy of Postgraduate Education 58 Korchagintsev str., Kharkiv, Ukraine, 61176

Candidate of Medical Sciences, Associate Professor

Department of Thoracoabdominal Surgery

Станислав Артурович Павличенко, Kharkov Medical Academy of Postgraduate Education 58 Korchagintsev str., Kharkiv, Ukraine, 61176

Candidate of Medical Sciences, Associate Professor

Department of Endoscopy and Surgery

Александр Александрович Лермонтов, Kharkiv National Medical University 4 Lenina ave., Kharkiv, Ukraine, 61022

Candidate of Medical Sciences, Associate Professor

Department of Pediatric Surgery and Pediatric Anesthesiology

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Published

2015-09-28

Issue

Section

Medical