It is generally agreed that the acute renal failure is not an infrequent complication among the patients with obstructive jaundice, particularyly during immediate postoperative period. This is also considered due to systemic endotoxemia and
resulting
functional derangement.
The role of lactulose in preventing endotoxemia in obstructive jaundice has been investigated.
A prospective study was performed on 27 female Sprague-Dawley rats(200~250gm) underwent common bile duct ligation or sham operation. The experimental animals were allocated to one of three groups. Each group was administration of intra-peritoneal
E.
coli(107/ml) at l week after common bile duct ligation or sham operation.
Group 3 was given oral lactulose(10% solution, 30ml/day) for 3 days before administration of intraperitoneal E. coli. At 72 hours after administration of intraperitoneal E. coli, three groups were compared with each other in blood chemistry and
hepatic
and renal histologic changes.
@ES The result were:
@EN 1) Jaundice was appeared in group 2 and group 3. Blood levels of bilirubin and alkaline phosphatase increased from control value of 0.15±0.05mg%, 204±43.5 I.T to 7.58±0.76mg%, 311.4±58 I.U(group 2) and 8.23±0.24mg%, 243.8±62.1 I.U(group
3) at
10 days after surgery.
2) AST and ALT activities increascd from the control value of 89.52±18.55 U, 27±7.12 U to 190.5±45.14 U, 49.42±16.2 U(group 2) and 162.75±34.37 U, 45.67 ±14.4 U(group 3). Ascites formation was not detectable.
3) Serum BUN and creatinine were not changed significantly in each groups.
4) The hepatic histologic changes of group 2 were more significant Kupffer cell hyperplasia and portal inflammatory infiltration and fibrosis than group 3.
5) The renal histologic changes of group 2 were more significant in tubular cell necrosis and atrophy, tubular casts and interstitial inflammatory change than group 3.
These results suggest that prophlactic oral lactulose administration can reduce endotoxinrelated functional and histologic changes of liver and kidney in obstructive jaundiced rats with sepsis.
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