Table of Contents
HPB Surgery
Volume 1, Issue 1, Pages 21-27

Prevention of Endotoxaemia in Obstructive Jaundice — A Comparative Study of Bile Salts

1Department of Surgery, Royal Surrey County Hospital, Surrey, Guildford, UK
2FRCS, Department of Surgery, Mayday Hosptial, Thornton Heath, Croydon, CR4 7YE, UK

Accepted 14 March 1988

Copyright © 1988 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Systemic endotoxaemia is associated with postoperative renal dysfunction in obstructive jaundice, and can be prevented by the pre-operative administration of certain bile salts. In order to find the most effective bile salt for use in this condition, a comparison of the anti-endotoxic activities of different bile salts was performed. Bile salts were incubated in vitro with endotoxin and the resultant endotoxin level was measured with a quantitative limulus assay. The in vivo effects of different oral bile salts on the intestinal absorption of radiolabelled endotoxin from rats with obstructive jaundice were compared. The in vitro and in vivo anti-endotoxic activities of bile salts related to their known detergent activities. Deoxycholic acid and its conjugates were the most effective and should be the bile salts of choice for further clinical evaluation in obstructive jaundice in man.