SEARCH · PubMed Health

Results for “Jaundice, Obstructive”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 325 records · Page 18Linked to original sources

PubMed1986

Experimental and clinical study of lactulose in obstructive jaundice.

The role of lactulose in preventing endotoxaemia in obstructive jaundice has been investigated. A prospective study was performed on 24 consecutive patients with obstructive jaundice undergoing surgery. Twelve patients were given oral lactulose before operation and were compared with twelve controls. Endotoxaemia was reduced in peroperative portal (P less than 0.05) and postoperative systemic (P less than 0.05) blood samples in the lactulose treated group, and a significant fall (P less than 0.05) occurred in the postoperative 24 h creatinine clearances in controls compared with the lactulose treated group. Results from animal experiments in which oral lactulose reduced endotoxin related mortality in obstructive jaundice (P less than 0.05), and the in vitro demonstration of a direct anti-endotoxic action of lactulose suggest that its beneficial action is due in part to an inactivation of endotoxin.

Acute Kidney Injury↗

PubMed1989

[Experimental study on the interruption of hepatic blood flow in obstructive jaundice, with special reference to the causes of death and prolonged jaundice after biliary decompression].

The purpose of this investigation was to elucidate the influence of interruption of the hepatic blood flow on survival and on prolonged jaundice after biliary decompression in dogs with obstructive jaundice. There were three experimental groups. Two or three weeks after inducing obstructive jaundice by ligation of the common bile duct with cholecystectomy, the hepatic artery (group A), portal vein (group B) or both (group C) were interrupted for various intervals, with antibiotics administration. Biliary decompression was simultaneously performed with choledochoduodenostomy. The one week survival rate after the interruption of hepatic blood flow was more than 60% at 2 and 1 hours in group A, 20 and 10 minutes in group B, 10 and 5 minutes in group C at two and three weeks after biliary obstruction, respectively. Necrosis more than 50% of the liver was observed in early death cases. Edema and stasis in the bile canaliculi were markedly observed histologically in survivors in groups A and C, accompanied with significant elevations of serum T. Bil and GPT. The changes were greater in cases with longer periods of jaundice. In obstructive jaundice, hepatic artery occlusion causes hepatic necrosis, in spite of antibiotics administration, and may induce prolonged jaundice after biliary decompression. As an indicator of the prognosis, the serum total bile acid value was useful.

Animals↗

PubMedDate not supplied

Effect of percutaneous biliary drainage on serum levels of tumor markers in patients with obstructive jaundice.

BACKGROUND/AIMS: Some tumor markers such as CA 19-9 are shown to be increased in obstructive jaundice due to either benign or malignant causes. In this study the clinical importance of raised serum levels of tumor markers have been evaluated, with particular reference to obstructive jaundice and percutaneous biliary drainage. METHODOLOGY: We conducted a prospective longitudinal before-after trial. Twenty-one patients with obstructive jaundice were investigated, 5 with benign obstruction and 16 with malignant disease. All patients were examined with abdominal CT prior to biliary drainage. All patients underwent percutaneous transhepatic cholangiography, and 20 of 21 patients underwent percutaneous biliary drainage within 3 days after the CT examination. RESULTS: The mean CA 19-9 at presentation was lower in the group with benign disease (95 +/- 60.9 IU/mL) than those with malignancy (461.9 +/- 331.4 IU/mL). The mean CA 19-9 level in the benign group 1 week after drainage was 12 +/- 11.8 IU/mL. The mean CA 19-9 level in the malignant group after drainage was 249.7 +/- 279.5 IU/mL. CONCLUSIONS: A prominently high serum CA 19-9 level at the presentation and a high serum CA 19-9 level after successful biliary drainage should prompt investigation for a malignant etiology of obstructive jaundice.

Adult↗

PubMed2001

The anti-inflammatory effects of circulating fatty acids in obstructive jaundice: similarities with pregnancy-induced immunosuppression.

Rheumatoid arthritis (RA) is ameliorated during both obstructive jaundice and pregnancy. Previous studies of polymorphonuclear leukocyte (PMN) function during pregnancy have shown reductions in the stimulated release of arachidonic acid (AA) and leukotriene B4 (LTB4), and lower NADPH oxidase activity. These changes may account for the amelioration of RA. The cause of this reduction in PMN function appears to be a progressive change in circulating fatty acids (FA), with a reduction in polyunsaturated FA, predominantly AA. The NADPH oxidase responsible for the respiratory burst has a direct requirement for polyunsaturated FA, particularly AA. We investigated whether the same changes in PMN function and FA, occur during obstructive jaundice. Patients with biliary obstructions were investigated before and after surgical correction (n=14). Obstructive jaundice caused significant changes in the proportions of serum and cellular FA. There was a striking reduction in polyunsaturated FA, particularly AA (48% in serum, p<0.001; 42% in PMNs, p<0.001) and an increase in mono-unsaturated oleic acid (24% in serum, p<0.001; 15% in PMNs, p<0.005). Similar changes occurred in mononuclear cell FA. Jaundice also caused a significant reduction in PMN function. Respiratory burst activity was reduced by between 32% and 38% in response to physiological and non-physiological stimuli, and there were similar significant reductions in the release of AA and LTB4. These changes in stimulated PMN function were evident whether or not the cells were first primed with tumour necrosis factor alpha (TNFalpha). Incubation of PMNs from healthy donors in pooled serum from patients with obstructive jaundice caused a reduction of 32% in cellular AA and 38% in NADPH oxidase activity. These findings support the idea that circulating FA can regulate PMN inflammatory responsiveness. The FA-induced attenuation in PMN activity in both jaundice and pregnancy may explain their ameliorating effects upon RA.

Adult↗

PubMed2003

Obstructive jaundice as the presenting manifestation of Burkitt's lymphoma in a 4-year-old boy.

Obstructive jaundice often occurs as a late manifestation of non-Hodgkin's lymphoma (NHL), but has rarely been reported as a presenting manifestation, especially in children. We report a case of a 4-year-old boy with Burkitt's lymphoma (small non-cleaved cell NHL) who presented with obstructive jaundice, resulting from encasement of the common bile duct by the tumor. The patient underwent near-total excision of the tumor and biliary-enteric bypass to relieve the jaundice. Combined chemotherapy was not given because of refusal by his family. Two weeks after the operation, obstructive jaundice reappeared due to a large recurrent tumor compressing the liver hilum. He received chemotherapy and the jaundice disappeared within 6 days. Follow-up computed tomography 1 year later revealed total resolution of the tumor. Three conclusions are suggested by this case. First, although NHL presenting as obstructive jaundice is uncommon in children, it should be included in the differential diagnosis. Second, relief of obstructive jaundice can be effectively accomplished by chemotherapy alone. Third, chemotherapy should be given once NHL is diagnosed.

Burkitt Lymphoma↗

PubMed2004

Primary non-Hodgkin's lymphoma of the common bile duct presenting as obstructive jaundice.

Primary non-Hodgkin's lymphoma of the extrahepatic bile duct presenting as obstructive jaundice is an extremely rare disease. At this writing, a review of the medical literature disclosed 17 reported cases of primary non-Hodgkin's lymphoma arising from the extrahepatic bile duct. We, herein, report an additional case of obstructive jaundice caused by primary non-Hodgkin's lymphoma of the common bile duct, in a 21-year-old woman. Our patient showed clinical evidence of obstructive jaundice, and endoscopic retrograde cholangiopancreatography and abdominal magnetic resonance imaging demonstrated a long strictured segment of the common bile duct with proximal bile duct dilatation. These clinical and radiological findings resembled those of cholangiocarcinoma. Resection of the common bile duct tumor, cholecystectomy, lymph node dissection, and Roux-en-Y hepaticojejunostomy were carried out. Histology and immunohistochemistry of the resected specimen confirmed a diffuse large B-cell-type malignant lymphoma involving the common bile duct. She received four courses of combination chemotherapy, including cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), and 3060 cGy external irradiation. She has been well, without evidence of tumor recurrence, 17 months after the surgery. In summary, first, primary non-Hodgkin's lymphoma of the extrahepatic bile duct, despite its rarity, should be considered in the differential diagnosis of causes of obstructive jaundice. Second, an accurate histopathologic diagnosis and surgical resection, if feasible, combined with chemotherapy with or without radiotherapy may be the approach to offer a chance for cure.

Adult↗

PubMed1976

[Hypermethioninemia in the differential diagnosis of infantile obstructive jaundice (author's transl)].

In 7 infants suffering from obstructive jaundice we found transient high levels of methionine in serum. All cases had only intrahepatic cholestasis, especially with intrahepatic biliary hypoplasia, whereas other patients with extrahepatic biliary atresia and/or combination of extra- and intrahepatic obstructive jaundice always showed normal levels of methionine. Therefore hypermethioninemia seems to be helpful in differentiating the various causes of infantile obstructive jaundice.

Bile Ducts↗

PubMed2000

[Prognostic factors of clinical curative effect for malignant obstructive jaundice].

OBJECTIVE: To explore prognostic factors for clinical treatment of patients with malignant obstructive jaundice. METHODS: 17 variables from 216 consecutive patients with malignant obstructive jaundice admitted from 1990 to 1997 were included for statistical analysis. RESULTS: The overall mortality was 19.9% (43/216), and the morbidity 37.5% (81/216). The morbidity of radical operation was higher than that of palliative operation (P < 0.01). There was a highly significant correlation between mortality, morbidity, ASA grade and duration of jaundice (P < 0.01). No correlation was seen between the mortality, type of operation and cause of jaundice. There was a highly significant correlation between the morbidity and the type of operation. CONCLUSIONS: The choice of operation in patients with malignant obstructive jaundice is radical operation. Early diagnosis and choice of treatment are essential to improving carative effect.

Adult↗

PubMed2003

Interventional therapy of malignant obstructive jaundice.

OBJECTIVE: To assess the short-term results of interventional therapy for malignant obstructive jaundice. METHODS: In 82 patients with malignant obstructive jaundice, hepatocellular carcinoma was detected in 10 patients, carcinoma of gallbladder in 14, hilar biliary carcinoma in 22, pancreatic carcinoma in 20, and hilar metastatic carcinoma in 16. Percutaneous transhepatic biliary internal and/or external drainage (PTBIED) was performed in 61 patients and percutaneous transhepatic insertion of biliary stent (PTIBS) in 21. RESULTS: The level of total serum bilirubin (TSB) was reduced in 71 patients and less markedly in others. The level of TSB of the 61 patients was reduced from 450.12+/-113.51 micromol/L before operation to 240.25+/-107.81 micromol/L and 90.91+/-101.72 micromol/L 1 and 2 weeks after operation respectively. The TSB level of the 21 patients was reduced from 410.53+/-98.13 micromol/L to 270.23+/-115.64 micromol/L and 105.43+/-97.85 micromol/L 1 and 2 weeks after operation, respectively. No significant difference was found in the effect between PTBIED and PTIBS. Short-term complications developed in 33 patients. Seven patients died 30 days after operation. CONCLUSION: Interventional therapy may be simple, safe and effective in the treatment of malignant obstructive jaundice.

Adult↗

PubMed1980

Diagnosis of obstructive jaundice with nondilated bile ducts.

Obstructive jaundice with nondilated bile ducts was identified by percutaneous transhepatic cholangiography (PTC) in nine of 29 jaundiced patients in whom the etiology of the jaundice was not clearly established by clinical or laboratory means and no dilated ducts were seen at somography or computed tomography (CT). PTC was helpful in these none patients by: (1) differentiating obstructive from nonobstructive jaundice, (2) localizing the site and etiology of the obstructing lesion, and (3) determining operability.

Adenocarcinoma↗

PubMed1999

[The value of MR cholangiopancreatograghy in diagnosis of obstructive jaundice].

OBJECTIVE: To evaluate the diagnostic value of MRCP in finding positions and causes of obstructive jaundice. METHODS: Fourty-two patients with obstructive jaundice received MRCP examination. All patients were finally onfirmed operatively. RESULTS: The correct diagnostic rate of finding obstructive positions in MRCP was 100% and the correct rate of finding obstructive causes 78.57%. MRCP combined with MRI raised the accuracy of diagnosis of obstructive causes. (90.48%). All pathogenic changes have their own characteristics. CONCLUSIONS: MRCP in diagnosing obstructive jaundice is quite effective and safe because of its clear pictures without use of contrast medium and no complications.

Adult↗

PubMed1993

Metabolism of insulin and glucagon in liver and pancreas in dogs with obstructive jaundice.

Insulin and glucagon metabolism in the pancreas with obstructive jaundice caused by complete ligation of the common bile duct and in the cholestatic liver caused by hepatic duct ligation was evaluated experimentally using dogs. The isolated perfused pancreas in obstructive jaundiced dogs, which showed a low insulin response in the peripheral blood after intravenous glucose administration, revealed depression of insulin production and no change of glucagon production in response to cholecystokinin octapeptide. The extraction of insulin in the cholestatic lobe of the liver was decreased compared with that in the noncholestatic lobe. The extraction of glucagon, on the other hand, in the cholestatic lobe and in the noncholestatic lobe showed no significant difference. So the imbalance of glucose metabolism in obstructive jaundice does not depend on the enhanced extraction of insulin in the liver, but on the depression of insulin production in the pancreas.

Animals↗

PubMed1979

[Transhepatic biliary drainage for obstructive jaundice (author's transl)].

Sixty-five patients with obstructive jaundice out of a total of 71 patients, were treated successfully by PTCD. The markedly elevated total bilirubin and alkaline phosphatase in the serum were reduced significantly and the general condition of the patient improved rapidly. On the other hand, severe obstructive jaundice which had persisted for several weeks was not amenable to treatment in this way. Occlusion of the extrahepatic bile ducts by tumour was treated by internal PTCD; this provided satisfactory flow of bile into the duodenum for at least six months. PTCD is simpler for the patient than surgery and is therefore the method of choice in obstructive jaundice. Finally, PTCD can be used for the introduction of antibiotics for the treatment of suppurative cholangitis or liver abscesses. This rapidly leads to reduction in fever and absorption of the abscesses.

Alkaline Phosphatase↗

PubMed1977

Ultrasonography in obstructive jaundice.

The usefulness of ultrasonography in the preliminary evaluation of obstructive jaundice is described in 35 consecutive patients with icterus. Diagnosis was substantiated by laparotomy, autopsy, or liver biopsy. In 23 patients with dilated bile ducts at ultrasonography, obstruction by tumor, stone, or stricture was proven operatively. Obstructive jaundice was differentiated from hepatocellular jaundice in 86% of cases; the site of obstruction was noted to be correct in 85%. The accuracy in the diagnosis of obstructive jaundice was 100% in patients with moderate or severe icterus.

Cholelithiasis↗

PubMed2001

The relationship between protein kinase C signal pathway and the immunologic evaluation in patients with obstructive jaundice.

OBJECTS: To explore the roles of the protein kinase C (PKC) signal pathway in immunologic evaluation of patients with obstructive jaundice. METHODS: PKC from cytosolic and membrane fractions of peripheral blood lymphocytes (PBL) was isolated and purified, then its activities were determined by radioactive isotope gamma-32P-ATP-catalyzing assay. RESULTS: Total PKC activities in PBL in patients with obstructive jaundice were significantly (r = 0.64, P < 0.01) increased as compared to those in normal subjects. Moreover, the membrane PKC activities and their percentages of the total PKC activities were higher in the patients with obstructive jaundice than in normal subjects (r = 0.63, P < 0.05). The total PKC activities in PBL were significantly correlated with the levels of soluble IL-2 receptor (sIL-2R) (r = 0.67, P < 0.01) and the degree of jaundice (T-BIL) (r = 0.58, P < 0.01) in serum. CONCLUSIONS: The activities of the PKC signal pathway is related to the degree of T-BIL. PKC may be implicated in the activation of T-lymphocytes in patients with obstructive jaundice. It is suggested that the role of the PKC signal pathway may be important in the immune regulation and the assessment of pathosis in patients with obstructive jaundice.

Adult↗

PubMed1994

Increased cardiac endocrine activity after common bile duct ligation in the rabbit. Atrial endocrine cells in obstructive jaundice.

OBJECTIVE: This study investigated the pathogenesis of water and sodium metabolism derangements in obstructive jaundice. SUMMARY BACKGROUND DATA: Obstructive jaundice is associated with hypodipsia, depletion of extracellular water, alterations of the water and sodium regulating hormones, and an increased incidence of renal failure. Plasma atrial natriuretic factor (ANF) increases after common bile duct ligation in the rabbit. The present study was designed to investigate ANF-secreting cardiac atrial cells in this animal model. METHODS: Plasma ANF and the percentage of atrial cells staining for ANF were determined in jaundiced and sham-operated rabbits at 24 (group OJ-24, n = 11; group SO-24, n = 5) and 72 hours (group OJ-72, n = 11; group SO-72, n = 5) after surgery. The atrial ANF content was also determined. RESULTS: Plasma ANF was higher in jaundiced animals than in controls both at 24 (63 +/- 44 fmol/mL vs. 17 +/- 10 fmol/mL, p < 0.02) and at 72 hours (73 +/- 49 fmol/mL vs. 12 +/- 11 fmol/mL). In the two OJ groups, the percentage of positive ANF cells per 200-power field in the right atrial appendage was higher than in the SO groups both at 24 (62 +/- 11% vs. 31 +/- 12%, p < 0.003) and at 72 hours (56 +/- 18% vs. 31 +/- 12%, p < 0.01). Similar results were obtained in the right auricular wall. The percentage of positive ANF cells was significantly higher in the left atrium in which significant differences between the OJ and SO groups were also noted. The right atrial ANF content was higher in the OJ than in SO groups (437 +/- 323 pmol/mg of protein vs. 83 +/- 44 pmol/mg of protein). CONCLUSIONS: Cardiac endocrine activity is increased in experimental obstructive jaundice. ANF may be involved in the pathogenesis of the renal and water and sodium metabolic disturbances present in this disease.

Animals↗

PubMed1996

Comparison of ultrasonography and cholangiography (ERCP/PTC) in the differential diagnosis of obstructive jaundice.

Diagnostic accuracy of ultrasonography and cholangiography (ERCP/PTC) was compared in determining the site and nature of obstruction in obstructive jaundice. Ultrasound was performed in 50 patients with clinical diagnosis of obstructive jaundice. All patients subsequently underwent ERCP/PTC and/or surgery. ERCP was performed in 38 and PTC in 15 patients. The positive predictive value for the site and etiology of obstruction by ultrasonography was 94% and 86% respectively. In comparison, the cholangiography (ERCP/PTC) had positive predictive value of 100% in site and 98% in etiology. High degree of accuracy and non-invasiveness makes ultrasound as the primary radiological tool in the differential diagnosis of obstructive jaundice. ERCP is the gold standard for determining the precise level and cause of obstruction. PTC adds further to ultrasound based diagnosis of obstructive jaundice particularly in proximal obstruction and in ERCP failure.

Biliary Tract Neoplasms↗

PubMed2005

Multivariate analysis of factors associated with renal dysfunction in patients with obstructive jaundice.

BACKGROUND: The aim was to evaluate the factors determining preoperative renal dysfunction in patients with obstructive jaundice. METHODS: In a prospective cross-sectional observational study, 63 patients, 27 with benign and 36 with malignant obstructive jaundice, were investigated at admission and compared with 25 healthy control subjects. Variables analysed included extracellular body water (ECW) compartment, plasma levels of aldosterone, renin, atrial natriuretic peptide, vasopressin, nitric oxide, endothelin (ET) 1 and prostaglandin E2 (PGE2), urinary nitric oxide and PGE2, serum albumin and renal function. RESULTS: The metabolic profile of obstructive jaundice was characterized by a depletion of the ECW (P = 0.004), and increased plasma levels of atrial natriuretic peptide (P < 0.001), ET-1 (P = 0.044), vasopressin (P = 0.017), aldosterone (P = 0.005) and renin (P = 0.001). Increased plasma (P < 0.001) and urinary (P = 0.001) PGE2 levels were also found. Fifty-four per cent of patients had a creatinine clearance of less than 70 ml/min. In multivariate analysis, serum bilirubin, renin, ET-1, PGE2, decreased urinary sodium excretion and age were identified as predictors of renal dysfunction. CONCLUSIONS: Renal dysfunction in patients with obstructive jaundice was associated with the degree of biliary obstruction, age of the patient and reduced urinary sodium excretion. These alterations were closely related to derangements in sodium- and water-regulating hormones.

Atrial Natriuretic Factor↗