Immunological alterations in obstructive jaundice

Abstract

Patients with obstructive jaundice have a greater incidence of perioperative complications, especially sepsis. There seems to be a dysfunction of the immune system in these patients, due to various factors, including endotoxemia. This article deals with the immunologic effects, considering three aspects of the obstruction to the bile flow: (i) the absence of bile in the intestinal lumen, (ii) the mechanical obstruction of the bile flow and (iii) the acumulation of toxic substances. Adequate perioperative care has permitted a reduction in the mortality rates during the last decades, but strategies to reduce the morbidity continue to be studied.