ABSTRACT
Adverse reactions after intravascular administration of iodine-based contrast media are well-known. Nevertheless the same type of contrast media is also used for endoscopic retrograde cholangiopancreatography and systemic absorption of contrast media after mentioned procedure routinely occurs, not much is known about effects of widely used diatrizoates (Triombrast) on the hepato-pancreato-biliary system in case of cholelithiasis treatment. AIM: The aim of the present study was to determine the effectiveness and biosafety of diatrizoate contrast media in terms of complicated cholelithiasis healing using conventional and improved surgery treatment protocols based on set of biochemical markers. MATERIALS AND METHODS: The paper presents materials of clinical observation and biochemical analysis of 122 patients have been diagnosed with gallstone disease complicated by choledocholithiasis and cholangitis and biliary pancreatitis. Biochemical liver tests before and after surgery treatment using conventional and improved protocols were determined. RESULTS: Biochemical manifestations of hepatocellular injury included exceeded activity of γ-glutamyltranspeptidase and aminotrasferases as well as level of liver fatty acid-binding protein and bilirubin which were different between groups of patients with cholelithiasis who suffered from concomitant cholangitis and pancreatitis. Proposed management algorithm for patients with gallstone disease with concomitant cholangitis and pancreatitis links to get rid of endoscopic retrograde cholangiography with contrast agent from the conventional surgery treatment protocols because its most obvious downside. CONCLUSIONS: Patients with gallstone diseases revealed significant biochemical changes that should be successfully resolved after surgery treatment without endoscopic retrograde cholangio- pancreatography with contrast media because its hepatotoxic effect.
