THE EFFECT OF GRANULOCYTE COLONY STIMULATING FACTOR ON BACTERIAL TRANSLOCATION IN OBSTRUCTIVE JAUNDICE
SÜLEYMAN BOZKURT, FAİK ÇELİK, ÖZGÜR EKİNCİ
SSK Göztepe Eğitim Hastanesi, 4.Cerrahi Kliniği, İSTANBUL
In obstructive jaundice (OJ), a portal endotoxemia resulting from cholangitis and/or bacterial translocation (BTR) is seen which initiate the septic process and perpetuate multiple organ failure. In this study we investigated the effect of G-CSF on bacterial translocation in experimentally created OJ. Forty Wistar-Albino rats were divided into Group I: Control (K), Group II: Choledochal ligation performed (CL), Group III: CL+G-CSF treatment (10 microg/kg sc.),Group IV: Sham laparotomy (Sh). All experimental groups were sacrificed on seventh day postoperatively. The serum bilirubin, alkaline phosphatase, ALT, AST,(GT, LDH, glucose, albumine, BUN, creatinine (Cr) levels were measured. The mesenteric lymph node complexes were excised, homogenized in 3ml Ringer solution and plated on MacConkey agar and blood agar. Plates were cultured for 48 hours and colonization is expressed as the number of colony-forming units (CFU) per ml homogenate. No significant differences were detected between K and Sh groups. In groups CL and CL+G-CSF, OJ was detected biochemically. A difference was seen between groups CL and CL+G-CSF regarding the BUN and Cr levels. The level of BUN and CR in group CL+G-CSF was similar to that of K and Sh groups. Based on these findings, G-CSF was found to decrease the endotoxemia and so regulates the renal functions. The mostly isolated microorganisms were E.Coli and Klebsiella. Gram-positive aerobs and anaerobs were isolated less frequently. The CFU and BTR ratios were statistically significant between groups CL and CL+G-CSF (p<0.001 and p<0.01). G-CSF decreases the BTR in OJ, but the actual mechanism needs to be investigated.
Keywords: OBSTRUCTIVE JAUNDICE, BACTERIAL TRANSLOCATION, G-CSF