title: Endoscopic drainage aborts endotoxaemia in acute cholangitis.
abstract: Forty patients with acute calculous cholangitis had successful endoscopic drainage. Bile from nasobiliary drains and venous blood was collected at 0, 12, 24, 36 and 48 h after endoscopy. Endotoxin levels were measured by the chromogenic Limulus Amoebocyte Lysate assay. There was a significant reduction in both bile and serum endotoxin levels after endoscopic drainage (P < 0.001). Endotoxaemia occurred when bile endotoxin reached 10(3) EU/ml and rose exponentially beyond this threshold. Significant association was demonstrated between both bile and serum endotoxins to the clinical features of cholangitis (P < 0.05). No correlation was evident between serum endotoxin and the parameters of white cell count, serum bilirubin and alkaline phosphatase (r = 0.53, 0.00 and 0.00 respectively). Endoscopic drainage is effective in lowering bile and serum endotoxin levels and clinical signs and symptoms reliably predict endotoxaemia.
authors.affiliation: Department of Surgery, Chinese University of Hong Kong.
authors.forename: J Y
authors.initials: JY
authors.lastname: Lau
authors.forename: S C
authors.initials: SC
authors.lastname: Chung
authors.forename: J W
authors.initials: JW
authors.lastname: Leung
authors.forename: T K
authors.initials: TK
authors.lastname: Ling
authors.forename: M Y
authors.initials: MY
authors.lastname: Yung
authors.forename: A K
authors.initials: AK
authors.lastname: Li
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001646:Bile / Q000737:chemistry / Q000382:microbiology; D002761:Cholangitis / Q000601:surgery*; D002769:Cholelithiasis / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D016145:Endoscopy, Digestive System; D004731:Endotoxins / Q000378:metabolism; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014115:Toxemia / Q000517:prevention & control*
chemical_list: D004731:Endotoxins