Year 2012 Vol. 20 No 5

EXPERIMENTAL SURGERY

A.N. DZIASHUK, P.V. GARELIK

PHOTODYNAMIC THERAPY OF EXPERIMENTAL ACUTE CHOLECYSTITIS

EE «Grodno State Medical University»,
the Republic of Belarus

Objectives. To evaluate the effectiveness of the photodynamic therapy in the treatment of acute cholecystitis in experi-ment.
Methods. Acute phlegmonic cholecystitis was simulated in 18 laboratory animals (rabbits). Three groups were determined. In the 1st group (control one, 6 animals) an acute phlegmonic cholecystitis was modeled, treatment was not carried out. In the 2nd group (experimental one, 6 ani-mals) in two days after acute cholecystitis modeling, Ñhlorophyllipt solution was injected into the gallbladder without consequent low-intensity laser radiation. In the 3rd group (experimental one, 6 animals) in two days after acute cholecystitis modeling, Ñhlorophyllipt solution was injected into the gallbladder and in 10 minutes low-intensity laser radiation was applied. Clinical course was estimated, general and biochemical blood tests indexes as well as bacteriological, microscopic indexes of the gallbladder content were studied. Morphological analysis was carried out in case of animals’ death in the control group and in case of excluding from the experiment in the experimental groups.
Results. A severe form of acute phlegmonic cholecystitis transforming into a destructive one with a widespread diffuse peritonitis was developing in animals, which was the cause of animals’ death in the control group of animals which hadn’t been treated. In the experimental groups a positive dynamics was registered, which was most pronounced in the rabbits treated with photodynamic therapy (PDT): acute process was stopped faster in the gallbladder wall, there was no tendency of a chronic form development with sclerotic changes; in the laboratory data general and biochemical blood tests stabilization and decrease of bacterial and leukocytes contamination of the bile was faster than in the group without PDT.
Conclusions. Application of local intravesical photodynamic therapy of acute phlegmonic cholecystitis results in the marked relief of the inflammatory process in the gallbladder of rabbits and prevents its transition into destructive and chronic forms.

Keywords: acute cholecystitis, photodynamic therapy, Chlorophyllipt
p. 3 - 10 of the original issue
References

1. Vetshev PS, Shkrob OS, Bel'tsevich DG. Zhelchnokamennaia bolezn' [Cholelithiasis]. Moscow, RF: Med. gaz; 1998. 192 p.
2. Bandettini L, Magrini L, Nesi S, Marranci M, Mori S, Pace M. Etiopathogenic, diagnostic and therapeutic problems apropos of 2 observations of acute acalculous cholecystitis. Ann Ital Chir. 1997 May-Jun;68(3):361–72; discussion 372–74. [Article in Italian]
3. Ermolov AS, Upyrev AV, Ivanov PA. Khirurgiia zhelchnokamennoi bolezni: ot proidennogo k nastoiashchemu [Surgery of gallstones: from the past to the present]. Khirurgiia. 2004;(5):4–9.
4. Simopoulos C, Botaitis S, Polychronidis A, Tripsianis G, Karayiannakis AJ. Risk factors for conversion of laparoscopic cholecystectomy to open cholecystectomy. Surg Endosc. 2005 Jul;19(7):905–9.
5. Garelik PV, Dubrovshchik OI, Deshuk AN, Mileshko MI. Sovremennye tekhnologii lecheniia ostrogo kholetsistita [Modern technologies of treatment of acute cholecystitis]. Khirurgiia Vostoch Evropa. 2012;(1):14–20.
6. Dziashuk A, Dovnar I, Koleshko S. Percutaneous transhepatic sanative-decompression puncture of the gallbladder under ultrasound induction in purulent cholecystitis. Polish Journal of Surgery. 2011;(1):69–70.
7. Tolstykh PI, Koraboev UN, Shekhter AB, Tolstykh MP, Stranadko EF, Radzhabov AA, Usmanov DN. Eksperimental'noe obosnovanie primeneniia fotodinamicheskoi terapii dlia lecheniia gnoinykh ran [Experimental substantiation
of photodynamic therapy use for the treatment of septic wounds]. Lazer Meditsina. 2001;5:8–13.
8. Ishchuk AV, Leonovich SI. Ispol'zovanie fotodinamicheskoi terapii lazernym apparatom «Rodnik-1» s fotosensibilizatorom «khlorofillipt» v lechenii gnoinykh ran i troficheskikh iazv nizhnikh konechnostei [The use of photodynamic therapy by laser device "Rodnik-1" with a photosensitizer "Hlorofillipt" in the treatment of infected wounds and trophic ulcers of the lower extremities]. Novosti Khirurgii. 2008;16(1):44–54.
9. Kumova IV, Zhuk IG, Bragov MIu. Vliianie NILI i FDT na zazhivlenie tolstokishechnogo anastomoza v usloviiakh posleoperatsionnogo kalovogo peritonita [Effect of LILR and PDT on the healing of colonic anastomosis in postoperative fecal peritonitis]. Zhurn GrGMU. 2007;(3):58–61.
10. Kumova IV, Zhmakin AI, Zhuk IG. Mikrobiologicheskoe obosnovanie effektivnosti primeneniia fotodinamicheskoi terapii v kolorektal'noi khirurgii [Microbiological substantiation of the effectiveness of photodynamic therapy in colorectal surgery]. Med Zhurn. 2007;(1):58–60.
11. Ushkevich AL, Zhandarov KN, Prokopchik NI. Fotodinamicheskaia terapiia v lechenii ostrogo destruktivnogo pankreatita, parapankreatita v eksperimente [Photodynamic therapy in the treatment of acute destructive pancreatitis, parapancreatitis in experiment]. Novosti Khirurgii. 2010;18(5):12–19.

Address for correspondence:
230009, Respublika Belarus, g. Grodno, ul. Gorkogo, 80, UO «Grodnenskiy gosudarstvennyiy meditsinskiy universitet», kafedra obschey khirurgii,
e-mail: dziashuk@mail.ru,
Deshuk Anatoliy Nikolaevich
Information about the authors:
Dziashuk A.N. Post-Graduate Student of the Department of General Surgery of EE "Grodno State Medical University."
Garelik P.V. Doctor of Medical Sciences, Professor, Head of the Department of General Surgery of EE "Grodno State Medical University."
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