Remaxol in perioperative infusion therapy for patients with calculous obstructive jaundice: a multiple-center observational study

Objective. To analyze the effect of Remaxol (Inosine + Meglumine + Methionine + Nicotinamide + Succinic Acid) in perioperative infusion therapy (PITh) on bilirubinemia in patients with cholelithiasis (CL) complicated by obstructive jaundice (OJ). Material and methods. A multiple-center observational study included 283 patients with CL complicated by OJ. All patients underwent endoscopic papillosphincterotomy (EPST) with / without subsequent laparoscopic cholecystectomy (LC). Primary assessment of PITh efficacy was performed on days 6–7 after EPST. Bilirubinemia was compared with the day before EPST. A positive response to therapy was defined as normalization of total blood bilirubin or its reduction by 70%. Results. Factors influencing the efficacy of PITh in patients with OJ were identified. Positive response rate was 100% in patients receiving PITh with Remaxol proportion exceeding 80% (p=0.005). In case of Remaxol proportion >50%, positive response rate was 96.88% (p=0.001). In the group with Remaxol proportion <50%, positive response rate was 68% compared to the group with proportion >50% (p<0.001). Each 10% increase in proportion of Remaxol increased the probability of positive response to treatment by 13% (p=0.017). Conclusion. Inclusion of Remaxol (Inosine + Meglumine + Methionine + Nicotinamide + Succinic Acid) in perioperative PITh for patients with OJ may have a positive effect on total blood bilirubin and increase the likelihood of normalization of this parameter or significant (by ≥70%) reduction in 6–7 days after successful EPST.