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Keywords:

  • Bile salts;
  • ursodeoxycholic acid;
  • bile duct obstruction;
  • endotoxin;
  • kidney failure

Abstract

Forty patients with obstructive jaundice (bilirubin > 100 μmol/l) were entered into a randomized trial of oral ursodeoxycholic acid for 48 h before surgery versus no additional therapy. Pre-operative venous and operative portal total bile salt concentrations were higher in the bile salt treated patients (P < 0.001). Portal endotoxaemia during operation was reduced in ursodeoxycholic acid treated patients (P < 0.05). There was no significant difference in systemic venous endotoxaemia, renal function or postoperative morbidity or mortality. This study suggests pre-operative oral bile salt therapy may be of no clinical benefit in patients with obstructive jaundice.