| Summary: | Background. The treatment of patients with obstructive jaundice is still one of
the topical issues, due to the continuing unsatisfactory results. This is largely facilitated by
the dysfunction of the liver, the restoration of which, even with the correction of the passage
of bile, occurs slowly, which causes the preservation of homeostasis disorders. Detailed
knowledge of this issue will form the basis for the development of optimal therapy
regimens. The purpose of this research is to study the severity of endogenous intoxication
and the state of the hemostatic system in association with the functional status of the liver in
patients with non-tumor jaundice before operation and in the early postoperative period. Materials
and methods. We examined 36 patients with obstructive jaundice of benign origin
who underwent various surgical interventions aimed at restoring the passage of bile into the
duodenum. We devided pations into 2 groups: the 1st group (n = 18) – patients with mild
obstructive jaundice, the 2nd (n = 18) – severe. The diagnostic complex includes: assessment
of the syndrome of endogenous intoxication by the content of toxic products of hydrophilic
and hydrophobic nature in the blood; a number of indicators of the functional
state of the liver; assessment of the state of the hemostasis system according to thromboelastography
data. Results. It was found that in the preoperative time and in the early postoperative
period in patients with obstructive jaundice there are pronounced phenomena of endogenous
intoxication, disorders in the hemostatic system, which are associated with a disturbance
of the functional state of the liver. The expression of these changes is associated with the severity
of the pathology. In the mild form of obstructive jaundice, hemostatic changes are recorded
in the form of an increase in the clotting ability of blood while maintaining the activity
of the fibrinolytic system. In the severe obstructive jaundice, the functional potential of the
liver decreases, one of the manifestations of which is the modulation of the hemostasis system
in the form of hypocoagulemia and hyperfibrinolysis. Conclusions. The obtained clinical and
laboratory information in disorders of homeostasis and functional state of the liver has not
only academic, but also applied significance, determining the vector of pathogenetic therapy
of patients with mechanical jaundice in the early postoperative period.
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