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Published April 28, 2023 | Version v1
Journal article Open

Analysis of the Morphology of the Gastroduodenal Zone Mucous Membrane in Chronic Pancreatitis in Comorbidity with Chronic Viral Hepatitis C Under the Influence of Combined Hepatoprotection

Creators

  • 1. I. Horbachevsky Ternopil National Medical University, Ukraine

Description

Recently, in medicine, the influence of infectious, hepatobiliary, gastric and duodenogenic factors for the formation and course of chronic pancreatitis (CP) and chronic hepatitis C virus (CHCV) which was treated etiotropically is increasingly being studied. Hepatitis C virus (HCV) is an important infectious factor in CP, for which the ability to chronic course has been proven. The condition of the mucous membrane of the organs in the gastroduodenal zone (GDZ) in the combined course of CP and HCV is important for the patient’s quality of life, as well as for assessing the safety of the performed and planned restorative complex treatment of such patients.

The objective: to analyze the dynamics of morphological changes of the mucous membrane in the gastrointestinal tract of patients with CP in comorbidity with etiotropically treated HCV under the influence of a protocol therapeutic complex with the additional inclusion of hepatotrophic drugs.

Materials and methods. We analyzed the data of 55 patients with CP in comorbidity with HCV after etiotropic treatment of HCV, who were examined according to generally accepted algorithms and received a generally accepted complex of treatment according to the CP protocol.

The patients were divided into two groups: the 1st group – 20 patients who received a generally accepted complex of treatment according to the protocol (PC) for 3 months; the 2nd group – 35 patients who received treatment according to the PC with the additional inclusion of a hepatotrophic agent for 3 months. In all the patients before and after treatment a morphological study of biopsies of the mucous membrane of the stomach and duodenum was performed.

Results. In the course of the study, a significant improvement in the mucous membrane morphology of the GDZ of patients with a combination of CP and HCV was established after a course of treatment with the use of hepatoprotectors, namely: a decrease in lymphohistiocytic infiltration – by 3.97 times, restoration of the gland structure that did not undergo complete non-metaplastic atrophy – by 5,13 times, increased proliferation of the glandular epithelium as a sign of morphological restoration of the epithelium – 3.9 times, decrease in signs of epithelial dysplasia – 10.35 times, decrease in the number of erosions of the mucous membrane of the organs of the gastrointestinal tract – 2.6 times.

Conclusions. The higher efficiency and safety of the complex treatment with the additional inclusion of a combination of hepatotrophic agents on the morphological condition of the mucous membrane of the organs of the gastroduodenal zone have been substantiated.

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