title: The effects of obstructive jaundice on the brain: An experimental study.
abstract: OBJECTIVE
  The study aims to evaluate the alterations in the brain due to oxidative stress and lipid peroxidation resulting from obstructive jaundice.
  
  
  METHODS
  Forty-one Wistar albino rats were used in this study. Simple laparotomy was performed in the sham group (n = 5). In the remaining 36 rats, the common bile duct (CBD) was found and ligated. They were divided into six groups. Group I, Group II, and Group III were sacrificed at the 3(rd), 7(th), and 14(th) day of ligation, respectively. In Group Id, Group IId, and Group IIId ligated bile ducts were decompressed at the 3(rd), 7(th), and 14(th) day, respectively. One week after decompression these rats were also sacrificed and samples were taken.
  
  
  RESULTS
  After the CBD ligation, serum levels of bilirubin and malondialdehyde were found to be increased progressively in parallel to the ligation time of the CBD. After decompression these values decreased. In electron microscopy evaluation, the damage was found to be irreversible depending on the length of the obstruction period. In Group II, the damage was mostly reversible after the internal drainage period of 7 days. However in Group III, the tissue damage was found to be irreversible despite the decreased values of oxidative stress and bilirubin.
  
  
  CONCLUSIONS
  Ultrastructural changes in brain tissue including damage in the glial cells and neurons, were found to be irreversible if the CBD ligation period was >7 days and did not regress even after decompression. It is unreliable to trace these changes using blood levels of bilirubin and free radicals. Therefore, timing is extremely critical for medical therapies and drainage.
authors.affiliation: Acute Care Surgery and Surgical Critical Care, Department of General Surgery, Medical School, USC, Los Angeles, CA, USA; Department of General Surgery, Sevket Yilmaz Training and Research Hospital, Bursa, Turkey. Electronic address: edilektasli@gmail.com.
authors.forename: Evren
authors.initials: E
authors.lastname: Dilektasli
authors.affiliation: Department of General Surgery, Medical School, Hacettepe University, Ankara, Turkey.
authors.forename: M M
authors.initials: MM
authors.lastname: Ozmen
authors.affiliation: Department of General Surgery, Batman State Hospital, Batman, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Gundogdu
authors.affiliation: Department of General Surgery, Yunus Emre State Hospital, Eskisehir, Turkey.
authors.forename: Hayrettin
authors.initials: H
authors.lastname: Dizen
authors.affiliation: Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
authors.forename: H T
authors.initials: HT
authors.lastname: Besler
authors.affiliation: Department of Histology and Embryology, Medical School, Gazi University, Ankara, Turkey.
authors.forename: Candan
authors.initials: C
authors.lastname: Ozogul
mesh_terms: D000818:Animals; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001921:Brain / Q000473:pathology*; D005260:Female; D041781:Jaundice, Obstructive / Q000097:blood / Q000473:pathology* / Q000503:physiopathology; D015227:Lipid Peroxidation; D008315:Malondialdehyde / Q000097:blood; D008854:Microscopy, Electron; D018384:Oxidative Stress; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar
chemical_list: D015415:Biomarkers; D008315:Malondialdehyde; D001663:Bilirubin
keywords: astrocyte swelling; electron microscopy; malondialdehyde; obstructive jaundice; oxidative stress