Classification, diagnosis and patient management with gallbladder sludge (expert resolution)
DOI: 10.32364/2587-6821-2025-9-9-10
S.N. Mehtiyev1,2, S.R. Abdulkhakov3,4, D.S. Bordin5–7, K.L. Raikhelson1,8, N.N. Vetsheva9, Yu.A. Cucheryavyi10, I.G. Nikitin11, V.I. Simanenkov12, E.A. Kondrashina8, E.V. Pazenko1,8
1I.P. Pavlov First St. Petersburg State Medical University, St. Petersburg, Russian Federation
2Gastroenterology Center "Expert" LLC, St. Petersburg, Russian Federation
3Kazan (Volga Region) Federal University, Kazan, Russian Federation
4Kazan State Medical University, Kazan, Russian Federation
5A.S. Loginov Moscow Clinical Research Center, Moscow, Russian Federation
6Russian University of Medicine, Moscow, Russian Federation
7Tver State Medical University, Tver, Russian Federation
8St. Petersburg State University, St. Petersburg, Russian Federation
9Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation
10Ilyinskaya Hospital JSC, Krasnogorsk, Russian Federation
11Pirogov Russian National Research Medical University, Moscow, Russian Federation
12North-Western State Medical University named after I.I. Mechnikovю, St. Petersburg, Russian Federation
The aim of this work is to develop a consensus position on the definitions, diagnosis, and treatment tactics of biliary sludge (BS). During expert discussions, the issues related to the diagnosis and patient management with BS were clarified; a number of relevant questions were discussed, and viewpoints were identified that warrant further expert investigation. Special attention was paid to the role of ursodeoxycholic acid (UDCA) in the treatment and prevention of BS progression, the benefit–risk ratio associated with the use of UDCA in patients with BS, as well as the evidence base supporting UDCA use for this condition. Both the classification and the diagnostic and therapeutic approaches require further refinement. Thus, BS is recognized as a clinically significant condition. The development of a unified interdisciplinary position among gastroenterologists, surgeons, ultrasound specialists, and endoscopists regarding the diagnosis and patient management with BS is necessary. In patients at high risk of BS progression (development of cholelithiasis or surgical complications), the administration of UDCA is indicated.
Keywords: biliary sludge, cholelithiasis, ursodeoxycholic acid, ultrasonography.
For citation: Mehtiyev S.N., Abdulkhakov S.R., Bordin D.S., Raikhelson K.L., Vetsheva N.N., Cucheryavyi Yu.A., Nikitin I.G., Simanenkov V.I., Kondrashina E.A., Pazenko E.V. Classification, diagnosis and patient management with gallbladder sludge (expert resolution). Russian Medical Inquiry. 2025;9(9):606–613 (in Russ.). DOI: 10.32364/2587-6821-2025-9-9-
About the authors:
Sabir N. Mehtiyev — Dr. Sc. (Med.), Professor of the Department of Internal Diseases, I.P. Pavlov Moscow State Medical University; 6–8, Lev Tolstoy str., St. Petersburg, 197022, Russian Federation; Chief Medical Officer of the Gastroenterological Center "Expert" LLC; 16, letter A, room 25-H, Pionerskaya str., St. Petersburg, 197110, Russian Federation; ORCID iD 0000-0001-7367-9219
Sayyar R. Abdulkhakov — C. Sc. (Med.), Associate Professor, Head of the Department of Internal Diseases at the Institute of Fundamental Medicine and Biology of the Kazan (Volga Region) Federal University; 18, Kremlevskaya str., Kazan, 420008, Russian Federation; Associate Professor of the Department of Outpatient Therapy and General Medical Practice, Kazan State Medical University; 49, Butlerova str., Kazan, 420012, Russian Federation; ORCID iD 0000-0002-1509-6776
Dmitry S. Bordin — Dr. Sc. (Med.), Head of the Department of Pathology of the Pancreas, Biliary Tract and Upper Digestive Tract, A.S. Loginov Moscow Clinical Research Center; 86 build. 6, Entuziastov Road, Moscow, 111123, Russian Federation; Professor of the Department of Propaedeutics of Internal Medicine and Gastroenterology, N.A. Semashko Research and Educational Institute of Clinical Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; Professor of the Department of General Medical Practice and Family Medicine, Tver State Medical University; 4, Sovetskaya str., Tver, 170100, Russian Federation; ORCID iD 0000-0003-2815-3992
Karina L. Raikhelson — Dr. Sc. (Med.), Associate Professor, Professor of the Department of General Medical Practice (Family Medicine), I.P. Pavlov Moscow State Medical University; 6–8, Lev Tolstoy str., St. Petersburg, 197022,
Russian Federation; Professor of the Scientific, Clinical
and Educational Center of Gastroenterology and Dietetics, St. Petersburg State University; 7–9, Universitetskaya emb., St. Petersburg, 199034, Russian Federation; ORCID iD 0000-0002-8821-6142
Natalia N. Vetsheva — Dr. Sc. (Med.), Professor of the Department of Ultrasound Diagnostics, Russian Medical Academy of Continuous Professional Education; 2/1 build. 1, Barrikadnaya str., Moscow, 125993, Russian Federation; ORCID iD 0000-0002-9017-9432
Yuri A. Kucheryavy — C. Sc. (Med.), Associate Professor, Research Advisor of the Department of Gastroenterology, Ilyinskaya Hospital JSC; 5 build. 6, entrance 2/floor 5, room 14-2-3, Krasnogorsk, 143421, Russian Federation; ORCID iD 0000-0003-2014-5736
Igor G. Nikitin — Dr. Sc. (Med.), Professor, Head of the Department of Hospital Therapy named after Academician G.I. Storozhakov, Institute of Clinical Medicine, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117997, Russian Federation, ORCID iD 0000-0003-1699-0881
Vladimir I. Simanenkov — Dr. Sc. (Med.), Professor of the Department of Internal Diseases, Clinical Pharmacology and Nephrology, North-Western State Medical University named after I.I. Mechnikov; 41, Kirochnaya str., St. Petersburg, 191015, Russian Federation; ORCID iD 0000-0002-1956-0070
Elina A. Kondrashina — C. Sc. (Med.), Associate Professor of the Scientific, Clinical and Educational Center of Gastroenterology and Dietetics, St. Petersburg State University; 7–9, Universitetskaya emb., St. Petersburg, 199034, Russian Federation; ORCID iD 0000-0002-0142-0264
Ekaterina V. Pazenko — C. Sc. (Med.), gastroenterologist of the Outpatient Clinic with the Clinical and Diagnostic Center, I.P. Pavlov First Saint Petersburg State Medical University; 6–8, Lev Tolstoy str., St. Petersburg, 197022, Russian Federation; Junior Researcher at the Scientific, Clinical and Educational Center of Gastroenterology and Dietetics, St. Petersburg State University; 7–9, Universitetskaya emb., St. Petersburg, 199034, Russian Federation; ORCID iD 0000-0002-7590-8932
Contact information: Elina A. Kondrashina, e-mail: elalkon@rambler.ru
Financial Disclosure: Binnopharm Group provided the financing, but was not involved in the interpretation of the data or the publication preparation.
Conflict of interest: the expert council was held with the support of Binnopharm Group.
Received 22.06.2025.
Revised 15.07.2025.
Accepted 07.08.2025.
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