SIGNIFICANCE OF DRAINAGE OF BILE IN BILIARY TRACT INFECTION COMPLICATED WITH OBSTRUCTION OF BILE DUCT

With Special Reference to the Excretion of Antibotics into Human Bile Juice in Patients with Obstructive Jaumdice

Abstract

Thirteen patients with obstructive jaundice received 2 g of CEZ by constant intravenous infusion for 30 minutes. Percutaneous transhepatic cholangiography (PTC) was performed 30 to 120 minutes after the initiation of administration of CEZ. Bile was sampled by the PTC needle just after the correct puncture of intrahepatic bile duct before injection of radiopaque material, and CEZ concentration in bile was measured. CEZ concentration in bile with obstructive bile duct was under 9. 2, μg/ml in all patients. In over half of the patients, the concentration was under 1. 0 μg/ml.
On the other hand, when bile was sampled 5 to 15 minutes after the drainage of bile from the -needle, the concentration of CEZ rose up 1 to 250 times as high as that of before drainage.
And the CEZ concentration in bile was followed for 7 days after the construction of the drainage of bile duct.
In conclusion, CEZ transfer to bile in obstructive jaundice proved to be extremely poor. And the biliary decompression seems to be very important in treatment of biliary tract infection with obstructive jaundice.