The changes of intestinal permeability in patients with obstructive biliary disease / 대한내과학회지

ABSTRACT

BACKGROUND: Gut barrier dysfunction occurs in experimental models and humans of obstructive biliary disease. This phenomenon promotes infectious complications including bacterial translocation and intestinal endotoxemia. The aims of this study were to examine correlations between gut barrier dysfunction and clinical characteristics in obstructive biliary disease. METHODS: The intestinal permeability were measured in 18 normal healthy controls, 20 patients with cholestasis caused by benign disease and 23 of them with cholestasis caused by malignant disease (common bile duct cancer; 16, pancreatic head cancer; 5) by measuring 24 hour urine excretion of 51Cr-EDTA (51Cr-ethylenediaminetetraacetic acid). RESULTS: The increase in intestinal permeability in malignant cholestatic disease was more higher than benign cholestatic disease (p<0.05). The increase in intestinal permeability showed significant correlation with shortening of prothrombin and activated partial thromboplastin time (p<0.05). No significant correlation was found between the increase in intestinal permeability and pancreatitis, inflammation or liver function including the changes of serum bilirubin level in patients with obstructive biliary disease. CONCLUSION: The increase in intestinal permeability in obstructive biliary disease was more in malignant cholestatic disease than benign cholestatic disease. Activation of coagulation may be predictive factor for gut barrier dysfunction in patients with obstructive jaundice.