[The value of volatile fatty acids, citrulline and malondialdehyde for diagnosis of suppurative cholangitis in obstructive jaundice and choosing of optimal surgical approach (with commentary)].
OBJECTIVE
To define the role of volatile fatty acids, citrulline and malondialdehyde for diagnosis of suppurative cholangitis in obstructive jaundice and to define optimal surgical approach.


METHODS
We studied the results of examination and treatment of 87 patients with different hepatopancreatobiliary pathology complicated by obstructive jaundice. It was determined blood concentration and range of volatile fatty acids which are metabolites of facultative anaerobic and obligate anaerobic bacterial pathogens.


RESULTS
In 39 patients the defined levels of acetic, propionic, butyric and isovaleric acids contributed to accurate diagnosis of suppurative cholangitis. Statistically significant threshold concentrations of volatile fatty acids were revealed. These values facilitate detection of anaerobic microflora in suppurative cholangitis.


CONCLUSIONS
Research of contents of volatile fatty acids, citrulline and malondialdehyde contributes to early diagnosis of suppurative cholangitis in patients with obstructive jaundice and further objectifies an algorithm of surgical tactics.
Ivanovo State Medical Academy, Health Ministry of the Russian Federation, Russia.
A K
AK
Gagua
Ivanovo State Medical Academy, Health Ministry of the Russian Federation, Russia.
A I
AI
Strel'nikov
Ivanovo State Medical Academy, Health Ministry of the Russian Federation, Russia.
K S
KS
Val'kov
D001421:Bacteria, Anaerobic / Q000378:metabolism*; D002761:Cholangitis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology; D002956:Citrulline / Q000032:analysis*; D042241:Early Diagnosis; D005232:Fatty Acids, Volatile / Q000032:analysis*; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D008297:Male; D008315:Malondialdehyde / Q000032:analysis*; D008875:Middle Aged; D018579:Patient Selection; D015203:Reproducibility of Results; D013492:Suppuration / Q000175:diagnosis; D013514:Surgical Procedures, Operative / Q000379:methods
D005232:Fatty Acids, Volatile; D002956:Citrulline; D008315:Malondialdehyde