Biliary obstruction and wound healing, infection, renal function and bloodcoagulation : an experimental study in rats

The purpose of the study reported in this thesis, was to investigate the effects of biliary obstruction on wound healing, resistance to infection, renal function and blood coagulation. Disturbances in these processes are often reported in patients with obstructive jaundice, and may lead to postoperative complications and mortality. However, in a retrospective study of 6 7 patients undergoing pancreatoduodenectomy or total pancreatectomy in our own surgical department morbidity and mortality was not higher in patients with increased serum bilirubin levels (serum bilirubin > 50 ,u mol/I) than in non-jaundiced patients. Preoperative biliary drainage has been advocated in an attempt to reduce these postoperative complications and to lower the mortality rate. These drainage procedures, however, may cause considerable complications and even death. To which extent biliary drainage can restore the disturbances in wound healing, resistance to infection, renal function and blood coaguIation is not clear form the literature (chapter I).