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Updated: Jul 20, 2026

Bile Duct Ligation in Mice: Induction of Inflammatory Liver Injury and Fibrosis by Obstructive Cholestasis
Published on: February 10, 2015
Persistent systemic inflammatory response after stent insertion in patients with malignant bile duct obstruction
A B Ballinger1, J A Woolley, M Ahmed
1Digestive Diseases Research Centre, St Bartholomew's, London, UK.
Biliary drainage did not alter tumor necrosis factor alpha (TNF-alpha) or its receptors in patients with malignant bile duct obstruction. This suggests preoperative drainage may not reduce surgical risks in these patients.
Area of Science:
- Gastroenterology and Hepatology
- Surgical Oncology
- Immunology
Background:
- Malignant bile duct obstruction surgery carries high risks.
- Tumor necrosis factor alpha (TNF-alpha) is implicated in these complications.
Purpose of the Study:
- To assess the impact of biliary drainage on plasma levels of TNF-alpha, its soluble receptors (sTNFr), and other inflammatory cytokines.
- To understand the role of TNF-alpha in surgical outcomes for malignant bile duct obstruction.
Main Methods:
- Measured plasma concentrations of TNF-alpha, sTNFr-P75, interleukin 6 (IL-6), and IL-1 alpha.
- Analyzed 25 patients with malignant bile duct obstruction before and after endoscopic stent insertion.
Main Results:
- Biliary drainage effectively relieved jaundice.
- Plasma TNF-alpha and IL-1 alpha were undetectable.
- Soluble TNF receptor (sTNFr-P75) levels remained unchanged post-drainage and were higher than in controls.
- Interleukin 6 (IL-6) levels significantly decreased after biliary drainage.
Conclusions:
- TNF-alpha/sTNFr complex activation is not affected by biliary drainage in malignant bile duct obstruction.
- This lack of change may explain why preoperative drainage doesn't improve surgical morbidity and mortality.
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