The effect of preoperative internal and external biliary drainage on mortality of jaundiced rats
D. J. Gouma, J. C. Coelho, J. F. Schlegel, Y. F. Li and F. G. Moody
Mortality following abdominal infection induced by cecal ligation and
puncture was studied in rats with obstructive jaundice and after relief of
the obstruction by preoperative internal or external biliary drainage. Four
groups of adult Sprague-Dawley rats were used: common bile duct ligation
(BDL), BDL followed by internal drainage after two weeks, BDL followed by
external drainage after two weeks, and sham operation. The serum bilirubin
concentration was significantly increased in the BDL group and returned to
normal following internal and external drainage. Mortality in the sham
group was 16.5% and increased to 83.3% following BDL, but it decreased
significantly (25%) to near-normal values after preoperative internal
drainage. However, after external drainage no significant reduction in
mortality (63%) was found. These findings confirm the poor results of
preoperative external drainage in previous studies and establish the
efficacy of internal biliary drainage in a well-controlled experimental
model that has to be evaluated in the clinical situation.
