Biliary stones are the most common etiology of acute pancretitis (AP). Pathomechanism of this etiology is based on common channel theory of Opie. 113 patients with ABP were included in the study – 91 with mild (MABP) and 22 with severe form (SABP). 17 patients with cholelithiasis and choledocholithiasis served as controls. ERCP with endoscopic sfincterotomy were performed in the day of admission and laparoscopic cholecystectomy (LCH) within the next 24 hours. Bile specimens were taken from main bile duct (MBD) during ERCP and from gall bladder (GB) during LCH. Bacteriological cultures, bile acids (BA) concentration and total (T-IgA) and secretory (S-IgA) form of IgA concentration were assessed in bile. The bile among the patients with SABP was more frequently infected, particularly when obtained from GB. Most common pathogens found in cultures were G(-) bacteria but G(+) cultures and fungi were also significant. Mean concentrations of total and particular BA were increased in MBD and decreased in GB. The fraction of toxic, hydrophobic, secondary BA was increased in total concentration of BA in MBD in patients with SABP. Among patients with MABP and controls these values were lower and similar. The lowest mean concentration of S-IgA was found in MBD in patients with SABP. Among patients with MABP and the controls results were higher and comparable. The highest mean concentration ; of T-IgA was observed in the bile from GB in patients with SABP. Three measured parameters: S-IgA in GB, GCDCA in GB and T-IgA in MBD were isolated as predictive factors of SABP. Patients selected on the basis of these parameters may require particular therapeutic attention.
Mar 8, 2023
Nov 21, 2012
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http://dl.cm-uj.krakow.pl:8080/publication/930
Edition name | Date |
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ZB-110915 | Mar 8, 2023 |
Zasada, Jakub Paweł
Chmiel, Izabela
Cieszkowski, Jakub
Konarska-Bajda, Katarzyna
Sendur, Paweł
Sporek, Mateusz
Dembiński, Marcin
Dolecki, Mirosław