REVIEW ARTICLE
General Surgery
doi: 10.25005/2074-0581-2025-27-4-986-999
ACUTE CALCULOUS CHOLECYSTITIS COMPLICATED BY NONSPECIFIC REACTIVE HEPATITIS AND JAUNDICE: CURRENT TRENDS IN DIAGNOSIS AND TREATMENT

N.D. МUKHIDDINOV1, F.I. MАKHMADOV2, KH.F. NАZАRОV1

1Department of Surgical Diseases and Endosurgery, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan, Dushanbe, Republic of Tajikistan
2Department of Surgical Diseases No. 1 named after Academician K.M. Kurbonov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To outline the features of clinical course, diagnosis, and treatment options for acute calculous cholecystitis (ACC) complicated with secondary, nonspecific reactive hepatitis (NSRH) and jaundice.

Methods: The following databases were used to select publications: Web of Science, Cochrane, PubMed, Google Scholar, CyberLeninka, and eLibrary. The primary timeframe for the search covered the last 10 years, except for one seminal work from 2007, which holds particular historical significance. To optimize the search, the following keywords were used: acute calculous cholecystitis, nonspecific reactive hepatitis, jaundice, and cholecystectomy. From the more than 3,860 publications retrieved, 46 articles were chosen for critical and substantive analysis, as they best represent the current scientific understanding of this topic.

Results: Literature indicates a yearly increase in the number of minimally invasive surgeries for ACC complicated by secondary NSRH and jaundice. This rise can be attributed not only to the minimal invasiveness of laparoscopic techniques but also to improved visual control, which provides more precise, detailed visualization of liver tissue. This clarity allows identification of the obstructive cause of jaundice and enables appropriate, minimally invasive interventions when necessary. To accurately determine the origin of jaundice in cases of ACC complicated by NSRH, it is recommended to perform a thorough clinical, laboratory, and instrumental evaluation, including computed tomography (CT) and/or magnetic resonance cholangiopancreatography (MRCP). In patients with ACC complicated by NSRH and jaundice, laparoscopic techniques are particularly warranted. They facilitate not only laparoscopic cholecystectomy but also the option for simultaneous liver tissue biopsy to confirm NSRH definitively. NSRH is recognized as one of the most complex and poorly understood complications of ACC. A delayed diagnosis of this condition can often result in significant complications, contributing to cholestasis and even cirrhosis. The severity of these complications is primarily influenced by the duration of the pathological process and the extent of morphological changes in the gallbladder wall.

Conclusion: An analysis of publications from the past decade highlights a significant need to refine and optimize minimally invasive treatment approaches for ACC complicated by NSRH and jaundice. At present, there are no standardized or well-established methods for selecting the most appropriate surgical approach to ACC complicated by NSRH and jaundice. To enhance treatment effectiveness, it is essential to develop algorithms that account for the morphological features of destructive gallbladder changes and assess hepatic functional reserves. Consequently, establishing clear, objective criteria for determining the indications and contraindications of various minimally invasive interventions is crucial. These criteria would help improve surgical outcomes for this specific patient population.

Keywords: Acute calculous cholecystitis, nonspecific reactive hepatitis, jaundice, cholecystectomy.

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Authors' information:

Mukhiddinov Nuriddin Davlatalievich,
Doctor of Medical Sciences, Full Professor, Professor of the Department of Surgical Diseases and Endosurgery, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan
Scopus ID: 6504760685
ORCID ID: 0000-0002-6216-1067
Author ID: 390845
E-mail: nuridd@mail.ru

Makhmadov Farukh Isroilovich,
Doctor of Medical Sciences, Full Professor, Professor of the Department of Surgical Diseases No. 1 named after Academician K.M. Kurbonov, Avicenna Tajik State Medical University
Researcher ID: ADM-7167-2022
ORCID ID: 0000-0003-4838-3568
SPIN: 1246-8316
Author ID: 727885
E-mail: fimahmadov@gmail.com

Nazarov Khusrav Fayzalievich,
Postgraduate Student of the Department of Surgical Diseases and Endosurgery, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan
Researcher ID: NMJ-6494-2025
ORCID ID: 0009-0000-7350-9025
E-mail: khusrav.9595@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Makhmadov Farukh Isroilovich
Doctor of Medical Sciences, Full Professor, Professor of the Department of Surgical Diseases No. 1 named after Academician K.M. Kurbonov, Avicenna Tajik State Medical University

734026, Republic of Tajikistan, Dushanbe, Sino str., 29-31

Tel.: +992 (900) 754490

E-mail: fimahmadov@gmail.com


This work is licensed under a Creative Commons Attribution 4.0 International License.

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