Effects of different drainage procedures on levels of serum endotoxin and tumor necrosis factor in patients with malignant obstructive jaundice.
OBJECTIVE
To assess the influence of different drainage procedures on the levels of serum endotoxin and tumor necrosis factor (TNF) in patients with malignant obstructive jaundice (MOJ).


METHODS
The levels of endotoxin and TNF in 46 patients with MOJ were measured before and after cholangiojejunostomy (CJ) or external bile drainage (EBD).


RESULTS
In the CJ group, the levels of postoperative serum endotoxin and TNF 10 days after operation were significantly lower than those before operation (P<0.01). In the EBD group, no significant changes were observed in endotoxin and TNF levels before and after operation (P>0.05). No significant differences were seen between the two groups before operation (P>0.05), but the levels of endotoxin and TNF in the CJ group were significantly lower than those in the EBD group after operation (P<0.01).


CONCLUSIONS
Cholangiojejunostomy other than external bile drainage can decrease the levels of serum endotoxin and TNF effectively, although both of them are able to release jaundice. Cholangiojejunostomy should be performed as soon as possible for patients with unresectable malignant tumor.
Lab of Hepatobiliary Surgery, First Hospital, Xi'an Jiaotong University, Xi'an 710061, China. dryyj@sina.com
Yi-Jun
YJ
Yang
Jing-Sen
JS
Shi
Shu-Min
SM
Xie
De-Ting
DT
Zhang
Bing-Sheng
BS
Cui
D000328:Adult; D000368:Aged; D001646:Bile / Q000378:metabolism; D001661:Biliary Tract Neoplasms / Q000097:blood / Q000150:complications / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D004731:Endotoxins / Q000097:blood*; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000097:blood / Q000209:etiology / Q000601:surgery*; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
D004731:Endotoxins; D014409:Tumor Necrosis Factor-alpha