Хронические заболевания желчного пузыря и желчевыводящих путей в связи с широкой распространенностью, склонностью к прогрессированию с развитием холелитиаза, высокой частотой хирургических вмешательств и большими потерями по нетрудоспособности приобретают всю большую значимость среди патологии органов пищеварения. В статье рассматриваются патогенетические аспекты формирования и лечения патологии билиарного тракта. Основное место уделено бессимптомной желчнокаменной болезни, обосновывается стратегия ее консервативного лечения препаратами урсодезоксихолевой кислоты.
Chronic diseases of a gall bladder and biliary tract in connection with prevalence, tendency to progressing with development of a holelitiasis, high frequency of surgical interventions and big losses in disability gain all big importance among pathology of digestive organs. In article pathogenetic aspects of formation and treatment of pathology of a biliary tract are considered. The main place is given to asymptomatic cholelithiasis, the strategy of its conservative treatment is proved by medicines of ursodeoxycholic acid.
1. Ильченко А.А. Болезни желчного пузыря и желчных путей: Руководство для врачей. 2-е изд., перераб. и доп. М.: Медицинское информационное агентство, 2011. / Ilchenko A.A. Bolezni zhelchnogo puzyria i zhelchnykh putei: Rukovodstvo dlia vrachei. 2-e izd., pererab. i dop. M.: Meditsinskoe informatsionnoe agentstvo, 2011. [in Russian]
2. Галкин В.А. Заболевание желчного пузыря и желчевыводящих путей. Ростов-на-Дону: Феникс, 2014. / Galkin V.A. Zabolevanie zhelchnogo puzyria i zhelchevyvodiashchikh putei. Rostov-na-Donu: Feniks, 2014. [in Russian]
3. Буеверов А.О. Хронические заболевания желчного пузыря и желчевыводящих путей: краткое руководство для практикующих врачей. М.: Медицинское информационное агентство, 2015. / Bueverov A.O. Khronicheskie zabolevaniia zhelchnogo puzyria i zhelchevyvodiashchikh putei: kratkoe rukovodstvo dlia praktikuiushchikh vrachei. M.: Meditsinskoe informatsionnoe agentstvo, 2015. [in Russian]
4. Желчнокаменная болезнь. Учебно-методическое пособие. Под ред. А.А.Щеголева. М.: РНИМУ, 2015. / Zhelchnokamennaia bolezn. Uchebno-metodicheskoe posobie. Pod red. A.A.Shchegoleva. M.: RNIMU, 2015. [in Russian]
5. Ильченко А.А., Быстровская Е.В. Опыт применения Дюспаталина при функциональных нарушениях сфинктера Одди у больных, перенесших холецистэктомию. Эксперим. и клин. гастроэнтерология. 2002; 4: 21–2. / Ilchenko A.A., Bystrovskaia E.V. Opyt primeneniia Diuspatalina pri funktsionalnykh narusheniiakh sfinktera Oddi u bolnykh, perenesshikh kholetsistektomiiu. Eksperim. i klin. gastroenterologiia. 2002; 4: 21–2. [in Russian]
6. Ильченко А.А. Желчнокаменная болезнь. Лечащий врач. 2004; 4: 27–32. / Ilchenko A.A. Zhelchnokamennaia bolezn. Lechashchii vrach. 2004; 4: 27–32. [in Russian]
7. Tait N, Little JM. The treatment of gallstones. BMJ 1995; 311: 99–105.
8. Sakorafas HG, Milingos D, Peros G. Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy. Dig Dis Sci 2007; 52: 1313–25.
9. Khuroo MS, Mahajan R, Zargar SA et al. Prevalence of biliary tract disease in India: a sonographic study in adult population in Kashmir. /Gut. 1989;30(2):201–205.
10. Berger MY, van-der-Velden JJIM, Lijmer JG et al. Abdominal symptoms: Do they predict gallstones? A systematic review. Scand J Gastroenterol 2000; 35 (1): 70–6.
11. Jørgensen T, Kay L, Hougaard Jensen K. Which abdominal symptoms are due to stones in the gallbladder. Gastroenterology 1994; 106: A342.
12. Heaton KW, Braddon FEM, Mountford RA et al. Symptomatic and silent gall stones in the community. Gut 1991; 32 (3): 316–20.
13. Jorgensen T. Abdominal symptoms and gallstone disease: An epidemiological investigation. Hepatology 1989; 9 (6): 856–60.
14. WGO Practice Guideline – Asymptomatic Gallstone Disease. http://www.worldgastroenterology.org/guidelines/global-guidelines/asymptomatic-gallstone-disease
15. Ruhl CE, Everhart JE. Gallstone disease is associated with increased mortality in the United States. Gastroenterology 2011; 140: 508–16.
16. Grimaldi CH, Nelson RG, Pettitt DJ et al. Increased mortality with gallstone disease: results of a 20-year population-based survey in Pima Indians. Ann Intern Med 1993; 118: 185–90.
17. Lindkvist B, Appelros S, Manjer J, Borgström A. Trends in incidence of acute pancreatitis in a Swedish population: is there really an increase? Clin Gastroenterol Hepatol 2004; 2: 831–7.
18. Guarino MР, Cocca S, AltomareA et al. Ursodeoxycholic acid therapy in gallbladder disease, a story not yet completed. World J Gastroenterol 2013; 19 (31): 5029–34.
19. Thistle JL, Cleary PA, Lachin JM et al. The natural history of cholelithiasis: the National Cooperative Gallstone Study. Ann Intern Med 1984; 101: 171–5.
20. Ransohoff DF, Gracie WA, Wolfenson LB, Neuhauser D. Prophylactic cholecystectomy or expectant management for silent gallstones. A decision analysis to assess survival. Ann Intern Med 1983; 99: 199–204.
21. Gibney EJ. Asymptomatic gallstones. Br J Surg 1990; 77: 368–72.
22. Friedman GD. Natural history of asymptomatic and symptomatic gallstones. Am J Surg 1993; 165: 399–404.
23. Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long Term Eff Med Implants 2005; 15: 329–38.
24. Kapoor VK. Cholecystectomy in patients with asymptomatic gallstones to prevent gall bladder cancer: the case against. Indian J Gastroenterol 2006; 25: 152–4.
25. Ebert EC, Nagar M, Hagspiel KD. Gastrointestinal and hepatic complications of sickle cell disease. Clin Gastroenterol Hepatol 2010; 8: 483–9.
26. Kao LS, Kuhr CS, Flum DR. Should cholecystectomy be performed for asymptomatic cholelithiasis in transplant patients? J Am Coll Surg 2003; 197: 302–12.
27. Shiffman ML, Sugerman HJ, Kellum JM et al. Gallstone formation after rapid weight loss: a prospective study in patients undergoing gastric bypass surgery for treatment of morbid obesity. Am J Gastroenterol 1991; 86: 1000–5.
28. Gallstones and laparoscopic cholecystectomy. NIH Consens Statement 1992; 10: 1–28.
29. Sakorafas GH, Milingos D, Peros G. Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy. Dig Dis Sci 2007; 52: 1313–25.
30. Stiehl A, Czygan P, Kommerell B et al. Ursodeoxycholic acid versus chenodeoxycholic acid. Comparison of their effects on bile acid and bile lipid composition in patients with cholesterol gallstones. Gastroenterology 1978; 75: 1016–20.
31. Traverso LW. Clinical manifestations and impact of gallstone disease. Am J Surg 1993; 165: 405–9.
32. Fenster LF, Lonborg R, Thirlby RC, Traverso LW. What symptoms does cholecystectomy cure? Insights from an outcomes measurement project and review of the literature. Am J Surg 1995; 169: 533–8.
33. Festi D, Sottili S, Colecchia A et al. Clinical manifestations of gallstone disease: evidence from the multicenter Italian study on cholelithiasis (MICOL). Hepatology 1999; 30: 839–46.
34. Berhane T, Vetrhus M, Hausken T et al. Pain attacks in non-complicated and complicated gallstone disease have a characteristic pattern and are accompanied by dyspepsia in most patients: the results of a prospective study. Scand J Gastroenterol 2006; 41: 93–101.
35. Weinert CR, Arnett D, Jacobs D Jr, Kane RL. Relationship between persistence of abdominal symptoms and successful outcome after cholecystectomy. Arch Intern Med 2000; 160: 989–95.
36. Vetrhus M, Berhane T, Søreide O, Søndenaa K. Pain persists in many patients five years after removal of the gallbladder: observations from two randomized controlled trials of symptomatic, noncomplicated gallstone disease and acute cholecystitis. J Gastrointest Surg 2005; 9: 826–31.
37. Mertens MC, Roukema JA, Scholtes VP, DeVries J. Risk assessment in cholelithiasis: is cholecystectomy always to be preferred? J Gastrointest Surg 2010; 14: 1271–9.
38. Thistle JL, Longstreth GF, Romero Y et al. Factors that predict relief from upper abdominal pain after cholecystectomy. Clin Gastroenterol Hepatol 2011; 9: 891–6.
39. Shaffer E. Acalculous biliary pain: new concepts for an old entity. Dig Liver Dis 2003; 35 (Suppl 3): S20-S25.
40. DiBaise JK, Richmond BK, Ziessman HH et al. Cholecystokinin-cholescintigraphy in adults: consensus recommendations of an interdisciplinary panel. Clin Gastroenterol Hepatol 2011; 9: 376–84.
41. Gurusamy KS, Junnarkar S, Farouk M, Davidson BR. Cholecystectomy for suspected gallbladder dyskinesia. Cochrane Database Syst Rev 2009; 1: CD007086.
42. Friedman GD, Raviola CA, Fireman B. Prognosis of gallstones with mild or no symptoms: 25 years of follow-up in a health maintenance organization. J Clin Epidemiol 1989; 42 (2): 127–36.
43. Leuschner U, Leuschner M, Sieratzki J et al. Gallstone dissolution with ursodeoxycholic acid in patients with chronic active hepatitis and two year follow-up: a pilot study. Dig Dis Sci 1985; 30: 642–9.
44. Makino I, Tanaka H. From a choleretic to an immunomodulator: historical review of ursodeoxycholic acid as a medicament. J Gastroenterol Hepatol 1998; 13: 659–64.
45. Roma MG, Toledo FD, Boaglio AC et al. Ursodeoxycholic acid in cholestasis: linking action mechanisms to therapeutic applications. Clin Sci (Lond) 2011; 121: 523–44.
46. Tint GS, Salen G, Colalillo A et al. Ursodeoxycholic acid: a safe and effective agent for dissolving cholesterol gallstones. Ann Intern Med 1982; 97: 351–6.
47. May GR, Sutherland LR, Shaffer EA. Efficacy of bile acid therapy for gallstone dissolution: a meta-analysis of randomized trials. Aliment Pharmacol Ther 1993; 7 (2): 139–48.
48. Rubin RA, Kowalski TE, Khandelwal M et al. Ursodiol for hepatobiliary disorders. Ann Intern Med 1994; 121 (3): 207–18.
49. Petroni ML, Jazrawi RP, Pazzi P et al. Risk factors for the development of gallstone recurrence following medical dissolution. The British-Italian Gallstone Study Group. Eur J Gastroenterol Hepatol 2000; 12 (6): 695–700.
50. Villanova N, Bazzoli F, Taroni F et al. Gallstone recurrence after successful oral bile acid treatment. A 12-year follow-up study and evaluation of long-term post dissolution treatment. Gastroenterology 1989; 97 (3): 726–31.
51. Portincasa P, Ciaula AD, Bonfrate L, Wang DQ. Therapy of gallstone disease: What it was, what it is, what it will be. World J Gastrointest Pharmacol Ther 2012; 3: 7–20.
52. Lazaridis KN, Gores GJ, Lindor KD. Ursodeoxycholic acid ‘mechanisms of action and clinical use in hepatobiliary disorders’. J Hepatol 2001; 35: 134–46.
53. Okoro N, Patel A, Goldstein M et al. Ursodeoxycholic acid treatment for patients with postcholecystectomy pain and bile microlithiasis. Gastrointest Endosc 2008; 68 (1): 69–74.
54. Ros E, Navarro S, Bru C et al. Occult microlithiasis in ‘idiopathic’ acute pancreatitis: prevention of relapses by cholecystectomy or ursodeoxycholic acid therapy. Gastroenterology 1991; 101 (6): 1701–9.
55. Saraswat VA, Sharma BC, Agarwal DK et al. Biliary microlithiasis in patients with idiopathic acute pancreatitis and unexplained biliary pain: response to therapy. J Gastroenterol Hepatol 2004; 19 (10): 1206–11.
56. Testoni PA, Caporuscio S, Bagnolo F et al. Idiopathic recurrent pancreatitis: long-term results after ERCP, endoscopic sphincterotomy, or ursodeoxycholic acid treatment. Am J Gastroenterol 2000; 95 (7): 1702–7.
57. Gamboa A, Tian C, Massaad J et al. The Therapeutic Role of Ursodeoxycholic Acid in Digestive Diseases. Ann Gastroenterol Hepatol 2011; 2 (1): 43–9.
58. Sugerman HJ, Brewer WH, Shiffman ML et al. A multicenter, placebo- controlled, randomized, double-blind, prospective trial of prophylactic ursodiol for the prevention of gallstone formation following gastric- bypass-induced rapid weight loss. Am J Surg 1995; 169 (1): 91–6; discussion 96–7.
59. Shoheiber O, Biskupiak JE, Nash DB. Estimation of the cost savings resulting from the use of ursodiol for the prevention of gallstones in obese patients undergoing rapid weight reduction. Int J Obes Relat Metab Disord 1997; 21: 1038–45.
60. Tomida S, Abei M, Yamaguchi T et al. Long-term ursodeoxycholic acid therapy is associated with reduced risk of biliary pain and acute cholecystitis in patients with gallbladder stones: a cohort analysis. Hepatology 1999; 30: 6–13.
61. Guarino MP, Cong P, Cicala M et al. Ursodeoxycholic acid improves muscle contractility and inflammation in symptomatic gallbladders with cholesterol gallstones. Gut 2007; 56: 815–20.
62. Van de Heijning BJ, van de Meeberg PC, Portincasa P et al. Effects of ursodeoxycholic acid therapy on in vitro gallbladder contractility in patients with cholesterol gallstones. Dig Dis Sci 1999; 44: 190–6.
63. Guarino MP, Carotti S, Morini S et al. Decreased number of activated macrophages in gallbladder muscle layer of cholesterol gallstone patients following ursodeoxycholic acid. Gut 2008; 57: 1740–1.
64. Schwarz NT, Kalff JC, Türler A et al. Prostanoid production via COX-2 as a causative mechanism of rodent postoperative ileus. Gastroenterology 2001; 121: 1354–71.
65. Rebollar E, Arruebo MP, Plaza MA, Murillo MD. Effect of lipopolysaccharide on rabbit small intestine muscle contractility in vitro: role of prostaglandins. Neurogastroenterol Motil 2002; 14: 633–42.
66. Xiao ZL, Biancani P, Behar J. Role of PGE2 on gallbladder muscle cytoprotection of guinea pigs. Am J Physiol Gastrointest Liver Physiol 2004; 286: G82–G88.
67. Плотникова Е.Ю., Сухих А.С. Урсодезоксихолевая кислота вчера и сегодня. Терапевт. 2012; 7: 23–33. / Plotnikova E.Iu., Sukhikh A.S. Ursodezoksikholevaia kislota vchera i segodnia. Terapevt. 2012; 7: 23–33. [in Russian]
68. Плотникова Е.Ю., Сухих А.С. Урсодезоксихолевая кислота на отечественном фармацевтическом рынке. Гастроэнтерология (Прил. к журн. Consilium Medicum. 2018; 1: 36–42. / Plotnikova E.Yu., Suhih A.S. Ursodeoxycholic acid in the domestic pharmaceutical market. Gastroenterology (Suppl. Consilium Medicum). 2018; 1: 36–42. [in Russian]
________________________________________________
1. Ilchenko A.A. Bolezni zhelchnogo puzyria i zhelchnykh putei: Rukovodstvo dlia vrachei. 2-e izd., pererab. i dop. M.: Meditsinskoe informatsionnoe agentstvo, 2011. [in Russian]
2. Galkin V.A. Zabolevanie zhelchnogo puzyria i zhelchevyvodiashchikh putei. Rostov-na-Donu: Feniks, 2014. [in Russian]
3. Bueverov A.O. Khronicheskie zabolevaniia zhelchnogo puzyria i zhelchevyvodiashchikh putei: kratkoe rukovodstvo dlia praktikuiushchikh vrachei. M.: Meditsinskoe informatsionnoe agentstvo, 2015. [in Russian]
4. Zhelchnokamennaia bolezn. Uchebno-metodicheskoe posobie. Pod red. A.A.Shchegoleva. M.: RNIMU, 2015. [in Russian]
5. Ilchenko A.A., Bystrovskaia E.V. Opyt primeneniia Diuspatalina pri funktsionalnykh narusheniiakh sfinktera Oddi u bolnykh, perenesshikh kholetsistektomiiu. Eksperim. i klin. gastroenterologiia. 2002; 4: 21–2. [in Russian]
6. Ilchenko A.A. Zhelchnokamennaia bolezn. Lechashchii vrach. 2004; 4: 27–32. [in Russian]
7. Tait N, Little JM. The treatment of gallstones. BMJ 1995; 311: 99–105.
8. Sakorafas HG, Milingos D, Peros G. Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy. Dig Dis Sci 2007; 52: 1313–25.
9. Khuroo MS, Mahajan R, Zargar SA et al. Prevalence of biliary tract disease in India: a sonographic study in adult population in Kashmir. /Gut. 1989;30(2):201–205.
10. Berger MY, van-der-Velden JJIM, Lijmer JG et al. Abdominal symptoms: Do they predict gallstones? A systematic review. Scand J Gastroenterol 2000; 35 (1): 70–6.
11. Jørgensen T, Kay L, Hougaard Jensen K. Which abdominal symptoms are due to stones in the gallbladder. Gastroenterology 1994; 106: A342.
12. Heaton KW, Braddon FEM, Mountford RA et al. Symptomatic and silent gall stones in the community. Gut 1991; 32 (3): 316–20.
13. Jorgensen T. Abdominal symptoms and gallstone disease: An epidemiological investigation. Hepatology 1989; 9 (6): 856–60.
14. WGO Practice Guideline – Asymptomatic Gallstone Disease. http://www.worldgastroenterology.org/guidelines/global-guidelines/asymptomatic-gallstone-disease
15. Ruhl CE, Everhart JE. Gallstone disease is associated with increased mortality in the United States. Gastroenterology 2011; 140: 508–16.
16. Grimaldi CH, Nelson RG, Pettitt DJ et al. Increased mortality with gallstone disease: results of a 20-year population-based survey in Pima Indians. Ann Intern Med 1993; 118: 185–90.
17. Lindkvist B, Appelros S, Manjer J, Borgström A. Trends in incidence of acute pancreatitis in a Swedish population: is there really an increase? Clin Gastroenterol Hepatol 2004; 2: 831–7.
18. Guarino MР, Cocca S, AltomareA et al. Ursodeoxycholic acid therapy in gallbladder disease, a story not yet completed. World J Gastroenterol 2013; 19 (31): 5029–34.
19. Thistle JL, Cleary PA, Lachin JM et al. The natural history of cholelithiasis: the National Cooperative Gallstone Study. Ann Intern Med 1984; 101: 171–5.
20. Ransohoff DF, Gracie WA, Wolfenson LB, Neuhauser D. Prophylactic cholecystectomy or expectant management for silent gallstones. A decision analysis to assess survival. Ann Intern Med 1983; 99: 199–204.
21. Gibney EJ. Asymptomatic gallstones. Br J Surg 1990; 77: 368–72.
22. Friedman GD. Natural history of asymptomatic and symptomatic gallstones. Am J Surg 1993; 165: 399–404.
23. Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long Term Eff Med Implants 2005; 15: 329–38.
24. Kapoor VK. Cholecystectomy in patients with asymptomatic gallstones to prevent gall bladder cancer: the case against. Indian J Gastroenterol 2006; 25: 152–4.
25. Ebert EC, Nagar M, Hagspiel KD. Gastrointestinal and hepatic complications of sickle cell disease. Clin Gastroenterol Hepatol 2010; 8: 483–9.
26. Kao LS, Kuhr CS, Flum DR. Should cholecystectomy be performed for asymptomatic cholelithiasis in transplant patients? J Am Coll Surg 2003; 197: 302–12.
27. Shiffman ML, Sugerman HJ, Kellum JM et al. Gallstone formation after rapid weight loss: a prospective study in patients undergoing gastric bypass surgery for treatment of morbid obesity. Am J Gastroenterol 1991; 86: 1000–5.
28. Gallstones and laparoscopic cholecystectomy. NIH Consens Statement 1992; 10: 1–28.
29. Sakorafas GH, Milingos D, Peros G. Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy. Dig Dis Sci 2007; 52: 1313–25.
30. Stiehl A, Czygan P, Kommerell B et al. Ursodeoxycholic acid versus chenodeoxycholic acid. Comparison of their effects on bile acid and bile lipid composition in patients with cholesterol gallstones. Gastroenterology 1978; 75: 1016–20.
31. Traverso LW. Clinical manifestations and impact of gallstone disease. Am J Surg 1993; 165: 405–9.
32. Fenster LF, Lonborg R, Thirlby RC, Traverso LW. What symptoms does cholecystectomy cure? Insights from an outcomes measurement project and review of the literature. Am J Surg 1995; 169: 533–8.
33. Festi D, Sottili S, Colecchia A et al. Clinical manifestations of gallstone disease: evidence from the multicenter Italian study on cholelithiasis (MICOL). Hepatology 1999; 30: 839–46.
34. Berhane T, Vetrhus M, Hausken T et al. Pain attacks in non-complicated and complicated gallstone disease have a characteristic pattern and are accompanied by dyspepsia in most patients: the results of a prospective study. Scand J Gastroenterol 2006; 41: 93–101.
35. Weinert CR, Arnett D, Jacobs D Jr, Kane RL. Relationship between persistence of abdominal symptoms and successful outcome after cholecystectomy. Arch Intern Med 2000; 160: 989–95.
36. Vetrhus M, Berhane T, Søreide O, Søndenaa K. Pain persists in many patients five years after removal of the gallbladder: observations from two randomized controlled trials of symptomatic, noncomplicated gallstone disease and acute cholecystitis. J Gastrointest Surg 2005; 9: 826–31.
37. Mertens MC, Roukema JA, Scholtes VP, DeVries J. Risk assessment in cholelithiasis: is cholecystectomy always to be preferred? J Gastrointest Surg 2010; 14: 1271–9.
38. Thistle JL, Longstreth GF, Romero Y et al. Factors that predict relief from upper abdominal pain after cholecystectomy. Clin Gastroenterol Hepatol 2011; 9: 891–6.
39. Shaffer E. Acalculous biliary pain: new concepts for an old entity. Dig Liver Dis 2003; 35 (Suppl 3): S20-S25.
40. DiBaise JK, Richmond BK, Ziessman HH et al. Cholecystokinin-cholescintigraphy in adults: consensus recommendations of an interdisciplinary panel. Clin Gastroenterol Hepatol 2011; 9: 376–84.
41. Gurusamy KS, Junnarkar S, Farouk M, Davidson BR. Cholecystectomy for suspected gallbladder dyskinesia. Cochrane Database Syst Rev 2009; 1: CD007086.
42. Friedman GD, Raviola CA, Fireman B. Prognosis of gallstones with mild or no symptoms: 25 years of follow-up in a health maintenance organization. J Clin Epidemiol 1989; 42 (2): 127–36.
43. Leuschner U, Leuschner M, Sieratzki J et al. Gallstone dissolution with ursodeoxycholic acid in patients with chronic active hepatitis and two year follow-up: a pilot study. Dig Dis Sci 1985; 30: 642–9.
44. Makino I, Tanaka H. From a choleretic to an immunomodulator: historical review of ursodeoxycholic acid as a medicament. J Gastroenterol Hepatol 1998; 13: 659–64.
45. Roma MG, Toledo FD, Boaglio AC et al. Ursodeoxycholic acid in cholestasis: linking action mechanisms to therapeutic applications. Clin Sci (Lond) 2011; 121: 523–44.
46. Tint GS, Salen G, Colalillo A et al. Ursodeoxycholic acid: a safe and effective agent for dissolving cholesterol gallstones. Ann Intern Med 1982; 97: 351–6.
47. May GR, Sutherland LR, Shaffer EA. Efficacy of bile acid therapy for gallstone dissolution: a meta-analysis of randomized trials. Aliment Pharmacol Ther 1993; 7 (2): 139–48.
48. Rubin RA, Kowalski TE, Khandelwal M et al. Ursodiol for hepatobiliary disorders. Ann Intern Med 1994; 121 (3): 207–18.
49. Petroni ML, Jazrawi RP, Pazzi P et al. Risk factors for the development of gallstone recurrence following medical dissolution. The British-Italian Gallstone Study Group. Eur J Gastroenterol Hepatol 2000; 12 (6): 695–700.
50. Villanova N, Bazzoli F, Taroni F et al. Gallstone recurrence after successful oral bile acid treatment. A 12-year follow-up study and evaluation of long-term post dissolution treatment. Gastroenterology 1989; 97 (3): 726–31.
51. Portincasa P, Ciaula AD, Bonfrate L, Wang DQ. Therapy of gallstone disease: What it was, what it is, what it will be. World J Gastrointest Pharmacol Ther 2012; 3: 7–20.
52. Lazaridis KN, Gores GJ, Lindor KD. Ursodeoxycholic acid ‘mechanisms of action and clinical use in hepatobiliary disorders’. J Hepatol 2001; 35: 134–46.
53. Okoro N, Patel A, Goldstein M et al. Ursodeoxycholic acid treatment for patients with postcholecystectomy pain and bile microlithiasis. Gastrointest Endosc 2008; 68 (1): 69–74.
54. Ros E, Navarro S, Bru C et al. Occult microlithiasis in ‘idiopathic’ acute pancreatitis: prevention of relapses by cholecystectomy or ursodeoxycholic acid therapy. Gastroenterology 1991; 101 (6): 1701–9.
55. Saraswat VA, Sharma BC, Agarwal DK et al. Biliary microlithiasis in patients with idiopathic acute pancreatitis and unexplained biliary pain: response to therapy. J Gastroenterol Hepatol 2004; 19 (10): 1206–11.
56. Testoni PA, Caporuscio S, Bagnolo F et al. Idiopathic recurrent pancreatitis: long-term results after ERCP, endoscopic sphincterotomy, or ursodeoxycholic acid treatment. Am J Gastroenterol 2000; 95 (7): 1702–7.
57. Gamboa A, Tian C, Massaad J et al. The Therapeutic Role of Ursodeoxycholic Acid in Digestive Diseases. Ann Gastroenterol Hepatol 2011; 2 (1): 43–9.
58. Sugerman HJ, Brewer WH, Shiffman ML et al. A multicenter, placebo- controlled, randomized, double-blind, prospective trial of prophylactic ursodiol for the prevention of gallstone formation following gastric- bypass-induced rapid weight loss. Am J Surg 1995; 169 (1): 91–6; discussion 96–7.
59. Shoheiber O, Biskupiak JE, Nash DB. Estimation of the cost savings resulting from the use of ursodiol for the prevention of gallstones in obese patients undergoing rapid weight reduction. Int J Obes Relat Metab Disord 1997; 21: 1038–45.
60. Tomida S, Abei M, Yamaguchi T et al. Long-term ursodeoxycholic acid therapy is associated with reduced risk of biliary pain and acute cholecystitis in patients with gallbladder stones: a cohort analysis. Hepatology 1999; 30: 6–13.
61. Guarino MP, Cong P, Cicala M et al. Ursodeoxycholic acid improves muscle contractility and inflammation in symptomatic gallbladders with cholesterol gallstones. Gut 2007; 56: 815–20.
62. Van de Heijning BJ, van de Meeberg PC, Portincasa P et al. Effects of ursodeoxycholic acid therapy on in vitro gallbladder contractility in patients with cholesterol gallstones. Dig Dis Sci 1999; 44: 190–6.
63. Guarino MP, Carotti S, Morini S et al. Decreased number of activated macrophages in gallbladder muscle layer of cholesterol gallstone patients following ursodeoxycholic acid. Gut 2008; 57: 1740–1.
64. Schwarz NT, Kalff JC, Türler A et al. Prostanoid production via COX-2 as a causative mechanism of rodent postoperative ileus. Gastroenterology 2001; 121: 1354–71.
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Авторы
Е.Ю.Плотникова*, А.С.Сухих
ФГБОУ ВО «Кемеровский государственный медицинский университет» Минздрава России. 650056, Россия, Кемерово, ул. Ворошилова, д. 22а *eka-pl@rambler.ru
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E.Yu.Plotnikova*, A.S.Suhih
Kemerovo State Medical University of the Ministry of Health of the Russian Federation. 650056, Russian Federation, Kemerovo, ul. Voroshilova, d. 22a *eka-pl@rambler.ru