The Perioperative Correction of Homeostasis in Obstructive Jaundice

Abstract

Obstructive jaundice is a common abdominal abnormality showing a high incidence of postoperative hepatic failure associated with progressive endotoxicosis and metabolic disturbances. Objective: to evaluate the efficacy of the infusion agent Sterofundin-G-5 in the pre- and postoperative correction of metabolic disturbances and endotoxicosis in patients with obstructive jaundice. Subjects and methods. Fifty-three patients divided into 3 comparable patients receiving the equal volume of infusion therapy (60 ml/kg/day) were examined. Prior to and following surgery, Group 1 patients received Ringer’s solution and 10% glucose solution in a 1:1 ratio. In Group 2, the preoperative preparation did not differ from that in Group 1; Sterofundin-G-5 was postoperatively used. In Group 3, pre- and postoperative infusion was made using Sterofundin-G-5. Results. The effect of malate as a component of Sterofundin-G-5 on metabolic parameters, lipid peroxidation/antioxidative system, bilirubinemia, enzymemia, and endotoxicosis was investigated. Preoperative preparation using Sterofundin-G-5 was found to have a suppressing effect on the progression of detected abnormalities of the study parameters. It was established that it was necessary to combine pre- and postoperative administration of Sterofundin-G-5 for the prevention of the detected abnormalities of the study systems and for the reduction of the time of their postoperative compensation. Key words: obstructive jaundice, malate, metabolism, bilirubin, enzymemia, endotoxicosis.