Serum interleukin-6 levels in patients with biliary obstruction.

BACKGROUND/AIMS: The clinical significance of the interleukin-6 (IL-6) response in patients with biliary obstruction was studied. METHODOLOGY: This study included 30 patients who had biliary obstruction and underwent percutaneous transhepatic biliary drainage. Cases complicated by cholangitis were excluded. The serum levels of IL-6 and standard liver function tests were examined before and after biliary drainage. RESULTS: Serum IL-6 levels were significantly higher in patients with biliary obstruction compared to control subjects (p<0.05). After drainage, serum IL-6 levels decreased significantly (p<0.01). The patients with serum IL-6 levels exceeding 10 pg/ml were characterized by lower hepaplastin values, lower serum levels of total protein and albumin, higher mean age, and more frequently positive cultures of bile compared to those with serum IL-6 levels of less than 10 pg/ml. Serum IL-6 levels were correlated negatively with hepaplastin values and serum levels of total protein and albumin (p<0.05). CONCLUSIONS: These results suggest that subclinical biliary infection, liver dysfunction and advanced age promote the IL-6 response in patients with biliary obstruction. Such a cytokine response may disturb the physiologic immune response after the ensuing major operation and may be related to some post-operative complications.