The Effect of Biliary Decompression on Bacterial Translocation in Jaundiced Rats

摘要

Patients with obstructive jaundice are prone to septic complications after biliary tract operations.Restoring bile flow to the intestine may help to decrease the complication rate. The present study isaimed at evaluating the effect of biliary decompression on bacterial translocation in jaundiced rats.Sixty-six male Sprague-Dawley rats were randomly allocated to six groups subjected to common bileduct ligation (CBDL) and transection (groups 2–6) or sham operation (group 1). In groups and 2 theincidence of enteric bacterial translocation was determined 2 weeks after sham operation or CBDL. Ingroups 3–6, biliary decompression was achieved by performing a choledochoduodenostomy after 2weeks of biliary decompression. Bacterial translocation was then studied 1,2,3 and 5 weeks followingbiliary decompression.The rate of bacterial translocation to mesenteric lymph nodes in obstructive jaundice was significantlyhigher as compared with controls, and decreased with time to nil three weeks following biliarydecompression. The incidence of bacterial translocation was closely correlated (r= 0.844;p= 0.034) with serum alkaline phosphatase activity and seemed to fit with the morphological changes noted in thesmall intestine. The decrease in bacterial translocation, however, lags behind the recovery of liverfunction as measured by routine liver function tests and antipyrine clearance.Obstructive jaundice thus promotes bacterial translocation in the rat. Biliary decompression graduallydecreases the rate of bacterial translocation.