Postoperative Acute Renal Failure in Patients With Obstructive Jaundice

Öz

Postoperative acute renal failure in patients with obstructive jaundice remains a clinically significant complications. The results of prospective analysis of 54 patients undergoing biliary tract surgery show that the presence of obstructive jaundice is associated with a high incidence of acute postoperative renal failure. There were 11 (% 24.3) death within early postoperative period and 4 of this 11 patients death was due to acute renal failure. There was a highly significant correlation between the preoperative serum bilirubine BUN and creatinine level and postoperative mortality rate. There was not significant correlation with level of preoperative serum bilirubine, BUN and creatinin with mortality due to acute renal failure.

Anahtar Kelimeler

• jaundice,renal failure

Tıkanma Sarılıklı Hastalarda Postoperatif Akut Böbrek Yetmezliği

Öz

Tıkanma sarılıklı hastalarda posoperatif akut renal yetmezlik halen klinik olarak önemli bir komplikasyondur. Biliyer cerrahi girişim uygulanan 54 hastanın prospektif analiz sonuçları sarılık varlığında yüksek oranda akut renal yetmezlik insidansı olduğunu gösterdi. Erken postoperatif peryodda 11(%24,3) hasta öldü. Bu 11 hastanın 4 'ündeki ölüm nedeni akut böbrek yetmezliği idi. Preoperatif serum bilirubin, BUN ve kreatinini değerleri ile postoperatif mortalite arasında anlamlı ilişki vardı. Preoperatif serum bilirubin BUN ve kreatinin düzeyleri ilee akut böbrek yetmezliğine bağlı ölümler arasında anlamlı bir ilişki yoktu.

Anahtar Kelimeler

• sarılık,böbrek yetmezliği

Kaynakça

1. Bailey ME. Endotoxin, bile salts and renal function in obstructive jaundice.Br J Surg. 1976;63(10):774-778. doi:10.1002/bjs.1800631011
2. Allison MEM, Prentice CRM, Kennedy AC, Blumgart LH. Renal Function and other factors in obstructive jaundice. BrJ Surg. 1979;66(6):392-398.
3. Clrail CJ. Prevention of postopeerative renal failure in patients with obstructive jaundice: the role of bile salts. Br J Surg. 1983;70(10):590-595.
4. Wait RB, Kalmg KU. Renal failure complicating obstmctive jaundice. Am J Surg. 1989;157(2):256-263.
5. Pain JA, Clıail CJ, Bailey ME. Perioperative complications in obstructive jaundice: Therapeutic complications. Br J Surg. 1986;72:942-947.
6. Pitt HA, Cameron JL, Postier RG, Gadacz TR. Factors affecting mortality in biliary tract surgery. Am J Surg. 1981;141(1):66-72. doi: 10.1016/0002-9610(81)90014-3
7. Blamey SL, Fearon KCH, Gilmour WH, Osbome DH, Carter DC. Prediction of risk in biliary surgery. Br J Surg. 1983;70(9): 535-538. doi: 10.1002/bjs.1800700910
8. Dixon JM, Armstrong CP, Duffy SW, Davies GC. Factors affecting morbidity and mortality after surgery for obstructive jaundice: A review of 373 patients. Gut. 1983;24(9):845.

9. Scott-Conner CE, Grogan JB. The pathophysiology of biliary obstruction and its effect on phagocytic and immune function. The Journal of surgical research. 1994;57(2):316-336.
10. Armstrong CP, Dixon JM, Taylor TV. Davies GC. Surgical experience of deeply jaundiced patients with bile duct obstmction. BrJ Surg. 1984;72:234-238. doi: 10.1006/jsre.1994.1151
11. Cahill CJ, Pain JA, Bailey ME. Bile salts, endotoxin and renal function in obstructive jaundice. Surgery, gynecology & obstetrics. 1987;165(6):519-522.
12. Diamond T, Dolan S, Thompson RL, Rowlands BJ. Development and reversal of endotoxemia and endotoxin-related death in obstructive jaundice. Surgery. 1990;108(2):370-4.
13. Wait RB, Kahng KU. Renal failure complicating obstructive jaundice. Am J Surg. 1989; 157(2):256-63. doi: 10.1016/0002-9610(89)90540-0
14. Schouten JT. Operative therapy for pancreatic carcinoma. Am J Surg. 1986;151:626-630.
15. Mannel A, Da Silva JGC, Melissas J, Becker PJ. Morbidity and mortality in surgery for obstructive jaundice. S Afr J Surg. 1987;25(3):91-94.
16. Gillen P, Peel ALG. Failure to improve survival by improved diagnostic techniques in patients with malignant jaundice. Br J Surg. 1986;73(8);631-633. doi: 10.1002/bjs.1800730817
17. Pellegrini CA, Allegra P, Bongard FS, Way LW. Risk of biliary surgery in patients with hyperbilirubinemia. The American journal of surgery. 1987;154(1):72-78. doi:10.1016/0002-9610(87)90299-6
18. Burdiles P, Csendes A, Diaz JC,et al. Faclor affecting mortality in patients over 70 years of age submitted to surgery for gallbladder or common bile duct stones. Hepatogastroenterology. 1989;36:136-139.
19. McSherry CK, Glenn F. The incidence and causes of death following surgery for nonmalignant biliary tract disease. Annals of Surgery. 1980;191(3):271. doi:10.1097/00000658-198003000-00003
20. Csendes A, Diaz JC, Burdiles P, Maluenda F, Morales E. Risk factors and classification of acute suppurative cholangitis. British journal of surgery. 1992;79(7):655-658. doi:10.1002/bjs.1800790720
21. Makela J, Kairaluoma MI. Relaparotomy for postoperative intra‐abdominal sepsis in jaundiced patients. British journal of surgery. 1988;75(12):1157-1159. doi: 10.1002/bjs.1800751204
22. Fogarty BJ, Parks RW, Rowlands BJ, Diamond T.Renal dysfimclion in obstructive jaundice.Br J Surg. 1995;82:877-884.
23. Hishida A, Honda N, Sudo M, Nagase M. Mechanisms of altered renal perfusion in the early stage of obstructive jaundice. Kidney international. 1980;17(2):223-230. doi:10.1038/ki.1980.25
24. Utkan T, Sarioglu Y, Utkan NZ, Gönüllü NN, Yildirim MK. Vascular smooth muscle reactivity and endothelium derived relaxing factor in experimental obstructive jaundice. Archives of physiology and biochemistry. 1996;104(1):30-35. doi:10.1076/apab.104.1.30.12864
25. Wilkinson SP, Moodie H, Stamatakis JD, Kakkar VV, Williams R. Endotoxaemia and renal failure in cirrhosis and obstructive jaundice. Br Med J. 1976;2(6049):1415-1418.