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Results for “Jaundice, Obstructive”

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At least 163 records · Page 9Linked to original sources
PubMed1992

Use of a specific cholecystokinin receptor antagonist (L-364,718) to determine the role of cholecystokinin on feeding and body weight in rats with obstructive jaundice.

We conducted a study to examine the role of cholecystokinin in feeding behavior and weight change in rats with obstructive jaundice. Daily food and water intake, body weight, and short-term food intake were determined in two groups of rats with surgically induced obstructive jaundice and in control rats. One group of rats with obstructive jaundice was given L-364,718, a selective cholecystokinin receptor antagonist. Plasma bilirubin and cholecystokinin levels were measured in each rat before and 7 days after surgery. Daily food intake and body weight were decreased in obstructive jaundice rats compared with control rats during the first week after surgery (P less than .05); however, obstructive jaundice rats treated with L-364,718 had increased food intake and body weight (P less than .05). Short-term food intake measured for 30 minutes and 120 minutes in food-deprived obstructive jaundice rats was decreased when compared with control rats (P less than .05), but the obstructive jaundice rats given L-364,718 had increased short-term food intake (P less than .05). Water intake was similar between the two groups of rats. Plasma levels of cholecystokinin and bilirubin were increased in obstructive jaundice rats with and without L-364,718 treatment (P less than .05). The results support the concept that endogenously elevated levels of plasma cholecystokinin play an important role in decreased food intake and subsequent loss of body weight in rats with obstructive jaundice.

Animals↗
PubMed2002

Effects of melatonin and lactulose on the liver and kidneys in rats with obstructive jaundice.

The negative effects of obstructive jaundice (OJ) on the liver and kidneys cause high morbidity and mortality. In this study, the effects of melatonin (M) and lactulose (L) on the liver and kidneys were investigated by inducing OJ in 30 rats in five groups (n = 6): controls, sham, M, L, and M + L. In the treatment group, after the rats' biliary canals were tied and cut, 10 mg/kg M IM and 2 ml/day L p.o. was administered for 7 days. The histopathologic findings in the liver and kidneys, tissue malonyl dialdehyde (MDA) levels, and serum biochemistry were evaluated. In the M group, pathological histologic findings were less marked than in the other groups; investigation of kidney cross-sections revealed no significant differences among groups. In the jaundiced rats liver MDA levels were significantly higher compared to the control group ( P < 0.001), but no such difference was observed in kidney MDA levels ( P > 0.05). L did not cause any significant changes in tissue MDA levels. There were no differences among groups with regard to serum levels of liver enzymes and bilirubin. Serum urea was significantly less in the group that received L ( P < 0.001), but the groups showed no significant differences with respect to creatinine values ( P > 0.05). The increase in serum total cholesterol was significantly less in the M + L group than in the other groups ( P < 0.001). We conclude that in the rats in which obstructive jaundice was induced, M administration reduced liver and kidney injury, but L and M + L did not lead to significant improvement.

Analysis of Variance↗
PubMedDate not supplied

Adverse metabolic and microbiological effects of tube feeding in experimental canine obstructive jaundice.

BACKGROUND: Inadequate oral intake and poor absorption result in malnutrition in obstructive jaundice. Both malnutrition and obstructive jaundice promote bacterial translocation from the gut. This study was designed to test the efficacy of tube feeding in preventing malnutrition and in decreasing the metabolic and microbiological adverse effects in obstructive jaundice. METHODS: Forty adult mongrel dogs were studied and were allocated into one of four groups: group I (PO-control) underwent sham ligation of the common bile duct (CBDL) and was fed ad libitum on Portagen (Mead Johnson, Evansville, IN); group II (PO-CBDL) underwent CBDL and was ad libitum fed on the same formula; group III (FEG-control) underwent sham CBDL and received forced esophagogastric feeding (FEG) with Portagen; and group IV (FEG-CBDL) underwent CBDL and received FEG. All the animals underwent insertion of a F-12 feeding tube to the stomach from an esophagotomy wound on day 1 and the tube was used for continuous enteral feeding with Portagen over 4 h/d from day 2 until day 13 in groups III and IV. Fourteen days later, blood samplings were done and a laparotomy was performed to obtain liver, mesenteric lymph nodes (MLN), and terminal ileum for quantitative bacterial culture. Bacterial translocation to MLN and liver was represented by log10 CFU/g of tissue in this study. RESULTS: Both group II and IV animals with CBDL significantly lost body weight (p = .0001) and had a lower level of prealbumin (p = .0054). A significant increase in bacterial translocation to MLN and to liver occurred in groups II and IV (p = .0017 and .0268, respectively). Intestinal bacterial population was also higher in these two groups than in the other two controls (p = 0.0028). An increase in plasma ammonia level was found in dogs with CBDL (p = .0002) and in dogs with FEG (p = .003), compared with their respective controls. Three among 13 dogs in group IV died and no mortality occurred in the other groups (p = .223). CONCLUSIONS: Tube feeding fails to improve malnutrition in obstructive jaundice and is associated with intestinal bacterial overgrowth, promoting bacterial translocation to MLN and liver, precipitating liver dysfunction and consequently a higher mortality.

Animals↗
PubMed1994

The usefulness of biliary drainage for restoring liver function in obstructive jaundice.

In eighty patients with obstructive jaundice treated with percutaneous or endoscopic drainage, the results of biochemical liver-function tests (serum bilirubin, transaminase, gamma-glutamyl transferase, alkaline phosphatase, and albumin) were analyzed to evaluate the return of liver function after biliary decompression. Before decompression all the patients had increased serum concentrations of all the liver-function indicators measured. Conjugated bilirubin normalized within 7 days in 67.5% of the patients and within 14 days in 94.5%. The other serum responses normalized as follows: glutamic oxaloacetic transaminase (7 days in 45%, 14 days in 100%); glutamic pyruvic transaminase (7 days in 46.2%, 14 days in 100%); gamma-glutamyl transferase (7 days in 56.2%, 14 days in 89.1%); alkaline phosphatase (7 days in 52.5%, 14 days in 90.4%); and albumin (7 days in 100%, 14 days in 90.4%). The low mortality and morbidity rates in this series of patients with obstructive jaundice: 0% and 7% after endoscopic and 2.1% and 10.4% after percutaneous drainage suggest that biliary drainage has a valuable place in the preparation of jaundiced patients for surgery and in some cases provides a definitive intervention.

Adult↗
PubMed1988

[Study on mechanism of onset of endogenous endotoxemia during obstructive jaundice--with special reference to involvement of biliary infection].

To clarify how biliary infections affect onset of endogenous endotoxemia during obstructive jaundice, I tried to review the clinical result of 104 cases of obstructive jaundice, and conducted a Limulus test of portal and peripheral blood in 20 cases of obstructive jaundice and an animal study using 38 rabbits. In cases of obstructive jaundice complicated by biliary infections, clinical improvement of jaundice became significantly unfavorable, and the outcome of surgical operation was significantly inferior to the cases without biliary infections. The endotoxin positive rate in the portal blood of obstructive jaundice was 65% (13 of 20 cases), among which 10 cases (79.6%) was also positive in the peripheral blood. Of these 10 cases, 7 cases manifested endogenous endotoxemia with no infectious focus, and prognosis of these cases was poor. The endotoxin positive rate in portal blood of obstructive jaundice group was also significantly higher than that of non-jaundice group in animal study, and when the reticuloendothelial system was blocked, the endotoxin positive rate in the peripheral blood showed an increasing tendency. In the animal group with experimental cholangitis, all the endotoxin positive animals in the portal blood were also positive in the peripheral blood. This result suggests that biliary infections accelerate a decrease in the reticuloendothelial function during obstructive jaundice. From these results, endogenous endotoxemia seems to affect the onset of various complications during obstructive jaundice and unfavorable prognosis.

Adult↗
PubMed2002

The endoscopic retrograde cholangiopancreatographic manifestations of histopathologically diagnosed hepatocellular carcinoma with obstructive jaundice.

To study the manifestations of endoscopic retrograde cholangiopancreatography (ERCP) in patients of obstructive jaundice associated with HCC, 32 cases of histopathologically diagnosed HCC with obstructive jaundice were successfully examined with routine ERCP. 31 patients were demonstrated by ERCP as having malignant obstructive jaundice. Among them, 19 were hepatic perihilar bile duct stricture, 7 bile ductile tumorous thrombus, 3 perihilar bile duct stricture complicated with thrombus, 2 metastasis to hilar lymph node, and 1 common bile duct stone as proven by sphincterotomy. The malignant perihilar stricture was all of type III and IV by Bismuth standard of Klastin tumor. In patients identified as having bile duct tumor thrombus, by the Ueda classification, none was of type I and II; 1 type III a; 4 III b; 2 type IV. HCC with obstructive jaundice was mainly caused by the malignant infiltration of tumor, and most stricture was of serious nature. When major extra-hepatic bile duct was involved by tumor thrombus, obstructive jaundice might develop. Malignant perihilar stricture and tumor thrombus might coexist in some patients. Jaundice was rarely caused by hepatic hilar lymph node metastasis. Jaundice was not necessarily caused by tumors and sometimes, it might be caused by common bile stones. Care should be exercised in differentiation diagnosis in such patients.

Adult↗
PubMedDate not supplied

Recovery of liver functions following surgical biliary decompression in obstructive jaundice.

BACKGROUND/AIMS: Derangement of liver functions in obstructive jaundice has been known to influence surgical outcome. The pattern and time frame of liver function recovery in patients with surgical obstructive jaundice undergoing a bilioenteric anastomosis has not been comprehensively defined in human beings. METHODOLOGY: Fifty patients of obstructive jaundice who underwent a bilioenteric anastomosis had their liver function evaluated done by biochemistry (pre-operatively and postoperatively on day 1,4,7 and 6 weeks) and radionuclide mebrofenin scan (preoperatively and 6 weeks postoperative). RESULTS: The results have shown a constant and significant decline in serum bilirubin levels by day 4 (p=0.04), however the decline in serum levels was not uniformly progressive in 54% patients. The decline in serum alkaline phosphatase levels has been constant and progressive reaching significant levels by day 4(p=0.01). Serum transaminases showed an initial rise followed by a rapid fall, again achieving significant levels by day 4 (p=0.003 & 0.009). Serum albumin decreased on day 1 itself but remained static after that. On isotope scanning hepatic uptake showed uniform improvement with 92% of patients having achieved a normal uptake after 6 weeks. Gastrointestinal excretion of the isotope however was still delayed in 26% patients at 6 weeks. Almost all these patients had an abnormal bilirubin level decline in the immediate postoperative period. CONCLUSIONS: Hepatic functional recovery has been seen to start immediately following bilioenteric anastomosis and has usually completed itself by 6 weeks. Patients who show an abnormal recovery pattern based on bilirubin levels need to be observed for a longer time.

Adolescent↗