Approaches to the Treatment of Early Stage of Gallstone Disease in Children
Journal Title: Здоров`я дитини - Year 2013, Vol 7, Issue 50
Abstract
Objective: comprehensive assessment of the efficacy of ursodeoxycholic acid (Ukrliv suspension) in the treatment of early stage of a gallstone disease (GSD) in children. Methods of the Study. We examined 30 children aged from 4 to 18 years with early stage of gallstone disease. Duration of follow-up — 2 months. Diagnostic complex: clinical and anamnestic data, ultrasound examination (USE) of biliary tract with the functional load, tree-stage duodenal intubation, microscopy of bile in a direct and polarized light, the blood level of aspartate aminotransferase, alanine aminotransferase (AlAT), alkaline phosphatase (AP), total bilirubin, total cholesterol, lipoprotein profile. Results of the Study. In the study group the majority were girls (66.4 %). Children over 12 years amounted to 53.7 %. There were no differences in GSD incidence in isolated functional disorders of biliary tract and in combination with inflammatory diseases of the bile passages. The main clinical symptoms of GSD early stage in children are: abdominal pain (23 %), epigastric pain (21 %), aching pain in the right hypochondrium (19 %). The most common symptom in USE was heterogeneous bile in the lumen of the gallbladder (58 %). Biliary sludge (DS) with formation of putty-like bile was diagnosed in 31 % of cases, and with microlithiasis — in 11 % of patients. AP was increased in 28 % of children, AlAT in 12 %, and total bilirubin in 8 %. The prevailing lipid profile disorder was high-density lipoprotein decrease (42.6 %) and increase of low-density lipoprotein (30 %). All patients received 10 mg/kg/day of ursodeoxycholic acid (Ukrliv suspension; 250 mg/5 ml). Follow-up showed regression of clinical and ultrasound symptoms. The trend toward normalization of gallbladder and sphincter of Oddi function was found in 41 % of patients. The number of BS cases with heterogeneous bile cases decreased by 37 %, BS with putty-like bile — by 17 %, BS with microlithiasis — by 2 %. Conclusions. Diagnosis and treatment of GSD at the early stage make it possible to increase the efficacy of therapy in whole. It was noted that ursodeoxycholic acid (Ukrliv suspension) possesses high efficiency and safety in the treatment of early GSD stage in children.
Authors and Affiliations
O. G. Shadrin, Ye. V. Shutova
Keywords
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