a comprehensive assessment of hemostasis disorders in patients with non-tumor obstructive jaundice

The features of the hemostasis system were studied on 537 patients with non-cancerous obstructive jaundice at various stages of the disease. the present research included a comprehensive assessment of both vascular-platelet (assessment of capillary resistance, the number of desquamated endothelial cells, and platelets) and plasma hemostasis (determination of aptt, the level of soluble fibrin, tv, po, pti, and fibrinogen content). in addition, the indicators of xiia-dependent fibrinolysis and the d-dimer level were evaluated. it was found that at the initial (cholestatic) stage of the disease, hemocoagulation parameters were within the reference values. during the transition to the cytolysis stage, there was a consistent activation of platelet and plasma units of hemostasis due to hyperbilirubinemia and hypertransaminemia. in the third stage (cholangitis), the progressive endothelial damage was observed, leading to the consumption of coagulation factors and increased fibrinolysis. the data indicate the stages of hemostasis disorders in obstructive jaundice. in the initial stage, the coagulation system functioned normally. cytolysis develops endotheliotoxicosis with activation of platelet and plasma units, which creates a risk of thrombotic complications. in cholangitis stage, progressive activation of plasma hemostasis was observed with the development of hemorrhagic syndrome. the results of the study highlight the necessity for systematic monitoring of blood coagulation parameters and prompt correction of detected disorders for preventing intra- and postoperative complications in patients with obstructive jaundice.