Effects of different drainage procedures on levels of serum endotoxin and tumor necrosis factor in patients with malignant obstructive jaundice.

OBJECTIVE: 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). METHODS: The levels of endotoxin and TNF in 46 patients with MOJ were measured before and after cholangiojejunostomy (CJ) or external bile drainage (EBD). RESULTS: 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). CONCLUSIONS: 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.