Patients with obstructive jaundice are prone to septic complications after biliary tract operations.
Restoring bile flow to the intestine may help to decrease the complication rate. The present study is
aimed at evaluating the effect of biliary decompression on bacterial translocation in jaundiced rats.
Sixty-six male Sprague-Dawley rats were randomly allocated to six groups subjected to common bile
duct ligation (CBDL) and transection (groups 2–6) or sham operation (group 1). In groups and 2 the
incidence of enteric bacterial translocation was determined 2 weeks after sham operation or CBDL. In
groups 3–6, biliary decompression was achieved by performing a choledochoduodenostomy after 2
weeks of biliary decompression. Bacterial translocation was then studied 1,2,3 and 5 weeks following
biliary decompression.
The rate of bacterial translocation to mesenteric lymph nodes in obstructive jaundice was significantly
higher as compared with controls, and decreased with time to nil three weeks following biliary
decompression. The incidence of bacterial translocation was closely correlated (r = 0.844; p = 0.034) with serum alkaline phosphatase activity and seemed to fit with the morphological changes noted in the
small intestine. The decrease in bacterial translocation, however, lags behind the recovery of liver
function as measured by routine liver function tests and antipyrine clearance.
Obstructive jaundice thus promotes bacterial translocation in the rat. Biliary decompression gradually
decreases the rate of bacterial translocation.