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Effects of obstructive jaundice and external biliary diversion on bacterial translocation in rats
M Cakmakci1, B Tirnaksiz, M Hayran
1Department of General Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Objective:
To find out the rate of translocation of bacteria to visceral organs in obstructive jaundice, and whether the absence of bile within the intestine or the presence of obstructive jaundice itself promotes bacterial translocation.
Design:
Prospective, controlled experimental animal study.
Setting:
University hospital, Turkey.
Subjects:
40 Inbred albino rats weighing 160-220 g.
Interventions:
Three groups of rats were studied: sham operated controls (n = 15), ligation of the common bile duct (CBD) (n = 15), and CBD-ligation and proximal external biliary division through a Silastic catheter (n = 10). Specimens of distal small bowel mesenteric lymph nodes (MLN), liver, spleen, and lung were obtained on the 10th postoperative day, and quantitative bacteriological analysis done. Caecal aerobic microflora were also measured for qualitative and quantitative comparisons.
Results:
The translocation of bacteria to MLN, liver, and spleen, but not to the lungs, was slightly but not significantly increased by ligation of the CBD. Ligation of the CBD with simultaneous external biliary diversion caused increase translocation to all organs examined (with the increases to the MLN (p = 0.012), liver (p = 0.009), and spleen (p = 0.028) being significant). There was no difference in the raised bacterial counts in MLN and visceral organs after ligation of the CBD or biliary diversion. The pattern of caecal microflora did not change in any group.
Conclusions:
These findings suggest that the absence of bile from the gut may promote bacterial translocation to visceral organs.
