Yang Yi-Jun, Shi Jing-Sen, Xie Shu-Min, Zhang De-Ting, Cui Bing-Sheng
Lab of Hepatobiliary Surgery, First Hospital, Xi'an Jiaotong University, Xi'an 710061, China.
Hepatobiliary Pancreat Dis Int. 2003 Aug;2(3):426-30.
To assess the influence of different drainage procedures on the levels of serum endotoxin and tumor necrosis factor (TNF) in patients with malignant obstructive jaundice (MOJ).
The levels of endotoxin and TNF in 46 patients with MOJ were measured before and after cholangiojejunostomy (CJ) or external bile drainage (EBD).
In the CJ group, the levels of postoperative serum endotoxin and TNF 10 days after operation were significantly lower than those before operation (P<0.01). In the EBD group, no significant changes were observed in endotoxin and TNF levels before and after operation (P>0.05). No significant differences were seen between the two groups before operation (P>0.05), but the levels of endotoxin and TNF in the CJ group were significantly lower than those in the EBD group after operation (P<0.01).
Cholangiojejunostomy other than external bile drainage can decrease the levels of serum endotoxin and TNF effectively, although both of them are able to release jaundice. Cholangiojejunostomy should be performed as soon as possible for patients with unresectable malignant tumor.
评估不同引流方法对恶性梗阻性黄疸（MOJ）患者血清内毒素和肿瘤坏死因子（TNF）水平的影响。
对46例MOJ患者在胆肠吻合术（CJ）或外引流术（EBD）前后检测内毒素和TNF水平。
CJ组术后10天血清内毒素和TNF水平显著低于术前（P<0.01）。EBD组手术前后内毒素和TNF水平无显著变化（P>0.05）。两组术前无显著差异（P>0.05），但术后CJ组内毒素和TNF水平显著低于EBD组（P<0.01）。
尽管胆肠吻合术和外引流术均可解除黄疸，但胆肠吻合术比外引流术能更有效地降低血清内毒素和TNF水平。对于无法切除的恶性肿瘤患者应尽早行胆肠吻合术。
