THE EFFECT OF BILE SALT ADMINISTRATION ON THE ENDOTOXEMIA AND RENAL FAILURE IN RATS WITH OBSTRUCTIVE JAUNDICE
KAYHAN GÜNAY1, MEHMET KURDOĞLU1, CEMALETTİN ERTEKİN1, ESMA SÜRMEN2, ALİ AĞAÇFİDAN3, NEJAT SAVCI4
1İstanbul Tıp Fakültesi, Genel Cerrahi ABD, İSTANBUL
2 İstanbul Tıp Fakültesi, Biyokimya ABD, İSTANBUL
3İstanbul Tıp Fakültesi, Mikrobiyoloji ABD, İSTANBUL
4İstanbul Tıp Fakültesi, Onkoloji Enstitüsü, İSTANBUL
This experimental study was designed to re-evaluate the hypothesis that absence of flow of gastrointestinal bile salt is important in the pathogenesis of endotoxemia in obstructive jaundice. Forty male Wistar Albino rats weighing 175-225 g were divided into four groups. Group I animals served as unoperated controls, Group II rats had their common bile ducts ligated, Group III rats underwent the same operation and were also given sodium-deoxycholate (5mg/100g, orogastric), Group IV rats underwent sham ligation. Seven days later, the rats were killed, their organs cultured, gastrointestinal tract examined histologicatly, serum total bilirubin, alkali phophatase and transaminase concentrations were determined. Endotoxin levels were also simultaneously determined both in portal and central venous blood by using LAL (Limulus Amebocyte Lysate) test. The bilirubin levels of group II (8.7 mg%) and III (8.2 mg%) were elevated compared with other groups (p<0.05). The incidence of bacterial translocation was higher in the ligated (30%-70%) than in the control (10%-0), sham ligated (10%-10%) or bile salt given (20%-10%) groups (p<0.05). The bacteria levels in terminal ileum were 100-fold higher in the bile duct ligated rats comparing to bile-salt given and other groups (p<0.05). The mucosal apperance of the intestines from the control, sham ligated and bile-salt given groups was normal, in contrast, subepithelial edema throughout the villi was present in the ligated group.