Effects of Biliary Drainage in Obstructive Jaundice View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

1991

AUTHORS

B. J. Rowlands , T. Diamond , D. C. McCrory , W. D. B. Clements

ABSTRACT

Obstructive jaundice is often a clinical manifestation of diseases of the extrahepatic biliary system and pancreas. Surgical procedures in these patients are associated with significant mortality and morbidity due mainly to the development of postoperative complications such as sepsis, bleeding disorders and renal failure (Armstrong et al. 1984; Pain et al. 1985). Therapeutic endoscopic and radiological procedures carry similar risks although their frequency is less well documented. Clinical and experimental studies have identified several aetiological factors including hypotension, impaired nutritional status, impaired immune function, hepatic dysfunction and the presence of toxic substances (bilirubin, bile salts) in the circulation. Wardle and Wright (1970) reported an association between renal insufficiency and endotoxaemia in obstructive jaundice and since that time there has been increasing recognition of the role of circulating endotoxins in the development of many of the complications of obstructive jaundice (Wilkinson et al. 1976; Hunt 1980). This has led to the investigation of factors that result in the development of endotoxaemia, including the absence of intraluminal bile salts and impairment of immunological function. These in turn initiated studies on therapeutic measures to reduce endotoxaemia, such as oral replacement of bile salts, percutaneous and endoscopic decompression of the biliary tract, stimulation of immune function and the use of antibiotics and antiendotoxin agents (Diamond and Rowlands 1991). This chapter will concentrate on the critical evaluation of the effects of biliary drainage in obstructive jaundice in animal and clinical studies, and their implications for current therapeutic strategies. More... »

PAGES

19-28

References to SciGraph publications

  • 1982-05. The effect of cholestasis on hepatic clearance of bacteria in WORLD JOURNAL OF SURGERY
  • 1985-03. Biliary obstruction and susceptibility to biliary sepsis in rats in RESEARCH IN EXPERIMENTAL MEDICINE
  • Book

    TITLE

    Pancreatic Disease

    ISBN

    978-1-4471-3358-2
    978-1-4471-3356-8

    Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/978-1-4471-3356-8_2

    DOI

    http://dx.doi.org/10.1007/978-1-4471-3356-8_2

    DIMENSIONS

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