Liu JJ, Sun YM, Xu Y, Mei HW, Guo W, Li ZL. Pathophysiological consequences and treatment strategy of obstructive jaundice. World J Gastrointest Surg 2023; 15(7): 1262-1276 [PMID: 37555128 DOI: 10.4240/wjgs.v15.i7.1262]
Corresponding Author of This Article
Zhong-Lian Li, Doctor, MD, PhD, Professor, Department of Hepatobiliary and Pancreatic Surgery, Tianjin Medical University Nankai Hospital, No. 6 Changjiang Road, Tianjin 300102, China. nkyylzl@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jul 27, 2023; 15(7): 1262-1276 Published online Jul 27, 2023. doi: 10.4240/wjgs.v15.i7.1262
Pathophysiological consequences and treatment strategy of obstructive jaundice
Jun-Jian Liu, Yi-Meng Sun, Yan Xu, Han-Wei Mei, Wu Guo, Zhong-Lian Li
Jun-Jian Liu, Zhong-Lian Li, Department of Hepatobiliary and Pancreatic Surgery, Tianjin Medical University Nankai Hospital, Tianjin 300102, China
Yi-Meng Sun, Yan Xu, Wu Guo, Graduate School, Tianjin Medical University, Tianjin 300070, China
Han-Wei Mei, Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
Author contributions: Li ZL and Liu JJ wrote and edited the manuscript; Sun YM and Mei HW made the Figure of the manuscript; Xu Y and Guo W edited and formatted the manuscript; all authors have read and approved the final manuscript.
Supported byTianjin Municipal Education Commission Scientific Research Program, China, No. 2022KJ271.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong-Lian Li, Doctor, MD, PhD, Professor, Department of Hepatobiliary and Pancreatic Surgery, Tianjin Medical University Nankai Hospital, No. 6 Changjiang Road, Tianjin 300102, China. nkyylzl@163.com
Received: March 20, 2023 Peer-review started: March 20, 2023 First decision: April 21, 2023 Revised: April 29, 2023 Accepted: May 31, 2023 Article in press: May 31, 2023 Published online: July 27, 2023 Processing time: 123 Days and 11 Hours
Abstract
Obstructive jaundice (OJ) is a common problem in daily clinical practice. However, completely understanding the pathophysiological changes in OJ remains a challenge for planning current and future management. The effects of OJ are widespread, affecting the biliary tree, hepatic cells, liver function, and causing systemic complications. The lack of bile in the intestine, destruction of the intestinal mucosal barrier, and increased absorption of endotoxins can lead to endotoxemia, production of proinflammatory cytokines, and induce systemic inflammatory response syndrome, ultimately leading to multiple organ dysfunction syndrome. Proper management of OJ includes adequate water supply and electrolyte replacement, nutritional support, preventive antibiotics, pain relief, and itching relief. The surgical treatment of OJ depends on the cause, location, and severity of the obstruction. Biliary drainage, surgery, and endoscopic intervention are potential treatment options depending on the patient's condition. In addition to modern medical treatments, Traditional Chinese medicine may offer therapeutic benefits for OJ. A comprehensive search was conducted on PubMed for relevant articles published up to August 1970. This review discusses in detail the pathophysiological changes associated with OJ and presents effective strategies for managing the condition.
Core Tip: Obstructive jaundice is a complex condition with systemic effects, and its management requires a multidisciplinary approach. Adequate supportive measures and identification of the cause, location, and severity of obstruction are crucial for effective treatment. Surgical and endoscopic interventions, as well as medical treatment, can be valuable options, depending on the patient's condition. Therefore, a thorough understanding of the pathophysiology and a comprehensive approach to management are necessary for better outcomes.
