Pathophysiological consequences and treatment strategy of obstructive jaundice

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.

Keywords: Jaundice; Obstructive; Pathophysiology; Traditional Chinese medicine; Treatment strategy.

Figure 1

Pathophysiological consequences for obstructive jaundice.

Figure 2

The treatment for obstructive jaundice. PTCD: Percutaneous transhepatic cholangiodrainage; PTBS: Percutaneous transhepatic biliary stenting; ENBD: Endoscopic nasociliary drainage; ERBD: Endoscopic retrograde biliary drainage; EUS-BD: Endoscopic ultrasound-guided biliary drainage; LCBDE+LC: Laparoscopic common bile duct exploration with cholecystectomy.