The changes in the indexes of endohelial dysfunction in patients after cholecystectomy

Aim of the research:. To investigate the changes in the indexes of endothelial dysfunction (ED) and their role in the formation of chronic pancreatitis (CP) in patients with cholecystectomy (CE). Materials and methods. The study involved 96 patients who had CE conducted in terms of 2 to 8 years. The patients after CE were divided into 2 groups according to the presence or absence of pancreatic gland (PG) lesions. Group I consisted of 30 patients after CE, without lesions of the PG. Group II consisted of 66 patients with CP after CE. All of the patients had the level of von Willenbrand factor (vWF) and P-selectin (P-s) in the blood measured. Results: The vWF index, as one of the main biomarkers of ED, has increased, as endothelium is its main producer, the main function of which is associated with the maintenance of platelet adhesion to the damaged wall of vessels at its lesion. The number of vWF in blood serum was significantly increased in patients from group II (to 183.2 ± 7.7%) compared to the indexes of group I (125.6 ± 5.1%) and control group (96.5 ± 7.4%). Thus, the increase of the level of vWF can be regarded as an ED index, and indicate the damage of microcirculation in patients with CP after CE. A pronounced increase of the P-s index was observed in the blood serum of patients after CE. The changes were less prominent in patients after CE without PG damage (to 203.5 ± 9.9 ng/ml), although in patients with CP the index of P-s increased to 485.6 ± 11.2 ng/ml (p < 0.01), considering that in the control group it was 114.3 ± 4.6 ng/ml. The obtained increased indexes of P-s in patients from group II are associated with the presence of inflammatory changes in PG tissue, not excluding the damage in the microcirculation system. The increase of vWF indexes, that are synthesized by endothelium, point out the damage of the endothelium function in patients after CE. The processes of the induction of an inflammatory response are observed more often in patients with CP after CE, which is proven by the increase of P-s level. Moreover, all these changes point at the ED with the damage of endothelial homeostasis balance, and determine the damage in the system of microcirculation. Conclusions: The damage of endothelium functions is observed in patients after CE. The ED (changes in vWF indexes, P-s) is more prominent in patients after CE with CP than in patients without the damage of pancreas.