Pathophysiological consequences of obstructive jaundice and perioperative management

Pavlidis, Efstathios T; Pavlidis, Theodosios

doi:10.1016/j.hbpd.2018.01.008

Cited by 126 publications

(90 citation statements)

References 52 publications

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“…Although the hyperbilirubinemia induced apoptosis in renal tubular epithelial cell, the renal function did not deteriorate and the renal structure remained unchanged in only bilirubin injection group according to our study. Acute renal injury in jaundice patients results from a combination of factors such as hemodynamic disturbances and cytokines [32], and jaundice causing renal injury needs a long time [33]. In this study, we found that the hyperbilirubinemia deteriorated the impairment of renal function and morphological changes in RIRI.…”

Section: Discussionmentioning

confidence: 56%

Hyperbilirubinemia Induces Pro-Apoptotic Effects and Aggravates Renal Ischemia Reperfusion Injury

Liao

Song

et al. 2019

Nephron

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Aims: Hyperbilirubinemia is associated with postoperative acute kidney injury in patients undergoing cardiac surgeries. A high concentration of bilirubin could induce oxidative stress and cell apoptosis. The aim of this study was to investigate whether hyperbilirubinemia aggravated the renal tubule cells injury and the pro-apoptotic potential of bilirubin on renal ischemia reperfusion injury (RIRI). Methods: The human proximal tubular epithelial cell line HK-2 cells were challenged with a gradient concentration of bilirubin for 24 h. Cell injury was assessed by flow cytometry and MTT assay. Bilirubin was injected intraperitoneally into male Sprague-Dawley rats once every 12 h (100 mg/kg), 3 times in total. The same solvent volume without bilirubin powder was used as vehicle in non-bilirubin injection groups. The RIRI surgical procedure was a bilateral renal pedicles clamping (45 min) followed by 30 h reperfusion. The rats were divided into 4 groups: negative control (NC), similar surgical procedures without clamping; Bil, bilirubin injection for 36 h, then rats were sacrificed; RIRI, RIRI surgical procedures; Bil + RIRI, RIRI applied 6 h later than the first bilirubin injection, rats were sacrificed after another 30 h. Results: In vitro, bilirubin induced cell apoptosis and significantly decreased the cell viability of HK-2 cells. Bilirubin induced the active caspase 3 and phosphorylation of p38 in HK-2 cells. In vivo, serum creatinine was higher in Bil + RIRI compared with RIRI (p < 0.01). The tubular injury scores of hematoxylin and eosin and tubular necrosis scores of periodic acid-Schiff were higher in Bil + RIRI than these in RIRI (All p < 0.05). The number of Tunel-positive nuclei was higher in Bil + RIRI compared to RIRI (p < 0.001). The active caspase 3 and phosphorylation of p38 were higher and the Bcl2 was lower in Bil + RIRI compared to RIRI. Moreover, the apoptosis level was higher in Bil compared to NC. Conclusions: Our results reveal that the hyperbilirubinemia induces pro-apoptotic effects and aggravates RIRI.

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Section: Discussionmentioning

confidence: 56%

Hyperbilirubinemia Induces Pro-Apoptotic Effects and Aggravates Renal Ischemia Reperfusion Injury

Liao

Song

et al. 2019

Nephron

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“…It can cause damage to various tissues and organs in the body with the most serious leading to hepatic injury. Studies have demonstrated that the accumulation of inflammatory factors in liver tissues and abnormal serum biochemical indexes are important causes of hepatic injury (1)(2)(3). However, the specific mechanism of hepatic injury caused by OJ remains not fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine activates the PI3K/Akt pathway to inhibit hepatocyte apoptosis in rats with obstructive jaundice

et al. 2019

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Obstructive jaundice (OJ) is a common disease in clinical surgery. The present study aimed to determine the effects of dexmedetomidine (Dex) on hepatocyte apoptosis in rats with OJ and also to explore the underlying mechanism. A total of 30 adult male Sprague Dawley rats were randomly divided into 3 groups: Sham group, bile duct ligation (BDL) group, and BDL+Dex group. The serum liver function index, expression levels of serum inflammatory factor interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), and the liver pathological changes were compared amongst groups. The serum liver function index and expression levels of inflammatory factors in the BDL group and BDL+Dex group were higher compared with the sham group. The serum liver function index and expression levels of inflammatory factors were lower in the BDL+Dex group compared with the BDL group. The severity of hepatic injury was diminished in the BDL+Dex group compared with the BDL group. Compared with the sham group, the hepatocyte apoptosis rate increased significantly in the BDL group and BDL+Dex group. The present findings suggested that Dex improved the liver function of rats with OJ, reduced the production of inflammatory factors and inhibited the apoptosis of hepatocytes. Dex demonstrated a protective effect on liver damage potentially via activation of the phosphoinositide 3-kinase/protein kinase B signaling pathway.

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“…De acuerdo a la revisión de la literatura, para optimizar el manejo perioperatorio del paciente con ictericia obstructiva, se debe considerar otros aspectos como el drenaje biliar preoperatorio, el soporte nutricional, la evaluación cardiovascular, la fluidoterapia perioperatoria y la optimización hemodinámica son las principales consideraciones para el anestesiólogo y los médicos (3) . El manejo perioperatorio de la ictericia obstructiva es una medida esencial para mejorar el resultado después de la cirugía (38) . cOncLusIOnEs El promedio de edad fue cerca del sexagésimo año y más de la mitad de los casos eran del sexo femenino.…”

Section: Discussionunclassified

Preoperative Management of Obstructive Jaundice

et al. 2018

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Artículo Original REsuMEn Introducción: La ictericia obstructiva biliar es un síntoma que resulta de la colestasis. Las causas son variadas, pero es comúnmente debida a coledocolitiasis, estenosis de la vía biliar, tumores malignos biliopancreáticos y enfermedades metastásicas. Objetivo: Describir el manejo preoperatorio de la ictericia obstructiva. Metodología: Investigación observacional, con estudio retrospectivo, descriptivo de expedientes clínicos de pacientes con ictericia obstructiva, tratados en el Hospital Central "Dr. Emilio Cubas" de enero a diciembre de 2017. Resultados:

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Pathophysiological consequences of obstructive jaundice and perioperative management

Cited by 126 publications

References 52 publications

Hyperbilirubinemia Induces Pro-Apoptotic Effects and Aggravates Renal Ischemia Reperfusion Injury

Hyperbilirubinemia Induces Pro-Apoptotic Effects and Aggravates Renal Ischemia Reperfusion Injury

Dexmedetomidine activates the PI3K/Akt pathway to inhibit hepatocyte apoptosis in rats with obstructive jaundice

Preoperative Management of Obstructive Jaundice

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