İBRAHİM BERBER1, EMİN GÜRLEYİK1, GÜNAY GÜRLEYİK1, NEZAHAT GÜRLER2, LEVENT BİLGİÇ3

1Haydarpaşa Numune Hastanesi, Genel Cerrahi Kliniği, İSTANBUL
2İstanbul Tıp Fakültesi, Mikrobiyoloji Anabilim Dalı, İSTANBUL
3İstanbul Tıp Fakültesi, Biyokimya Anabilim Dalı, İSTANBUL

Abstract

Bacterial translocation from the gut occurring under different conditions, is accepted responsible for some infectious and metabolic complications in many patients. In this paper we studied the effects of sodium deoxycholate and glutamine on bacterial translocation during obstructive jaundice with an experimental model in rats. Forty rats were equally divided into four groups: Group 1 only sham laparotomy; group 2 common bile duct ligation; group 3 duct ligation and sodium deoxycholate; group 4 duct ligation and glutamine. Serum bilirubin, SGOT, SGPT, alkaline phosphatase, and creatinin levels were measured. Bacteriological analysis in the blood and in tissues of mesenteric lymph ganglion, liver, spleen, and intraluminal bacterial colonies count of the bowel were performed. Changes in the structure of ileal mucosa were examined histologically. Bacterial translocation to lymph ganglion was determined in 7 rats in group 2 (p=0.0098). Translocation decreased significantly in group 3 with two (p=0.035) and in group 4 with one (p=0.0098) positive findings. intraluminal bacterial colonies increased significantly in groups 2 and 4 (p<0.0001). In group 3 there was no increase of bacterial colonies despite obstructive jaundice. Microscopic structure and resistance of ileal mucosa was best preserved in group 4 with glutamine (p=0.193). We concluded that in rats with obstructive jaundice bacterial translocation from the gut is decreased with orally supplemented sodium deoxycholate by controlling intraluminal bacterial growth, and with glutamine by preserving structure and resistance of bowel mucosa.

Keywords: OBSTRUCTIVE JAUNDICE, BACTERIAL TRANSLOCATION, GUT, SODIUM DEOXCHOLATE, GLUTAMINE