ANERGY IN PATIENTS WITH OBSTRUCTIVE JAUNDICE

Abstract

Background: Surgery in patients with obstructive jaundice carries high risk with its severe morbidity and mortality. Anergy described as impairment in delayed cell mediated immune response carries high complication and sepsis rate, and mortality risk in surgical patients. The relationship of anergy and obstructive jaundice is assessed in a prospective nonrandomized study.

Method: Between September 1997- 1999 Multitest technique is used in 57 patients. Antigens are injected in the volar face of forearm and results assessed 48 hours later. Patients are grouped as immunocompetant, relatively anergic and anergic.

Results: Preoperatively two patients were relatively anergic in the control group. In the study group 14 patients were relatively anergic and 18 were anergic. In the postoperative assessment 12 patients were immunocompetant, 8 were relatively anergic and 12 were anergic.

Conclusion: Being aged, malignancy, sepsis, protein- energy malnutrition, trauma and surgical operations are factors supressing the delayed cell mediated immunity. Patients whom anergic preoperatively and remaining anergic postoperatively has worse prognosis, complications and mortality, in comparison to patients whom anergy is better.