Relationship between Reduction Rate of Serum Bilirubin Level, Factors in Prolonged Jaundice and Serum Type IV Collagen (7S Domain) Levels in Patients with Obstructive Jaundice

Noriyasu Komine, Kazuo Hatsuse, Satoshi Saito, Satoshi Shono, Hideki Aoki, Takeyuki Idei, Michinori Murayama, Yoshihiro Sakai, Minoru Kakihara, Shoetsu Tamakuma

The First Department of Surgery, National Defense Medical College

We studied the relationship between reduction rate of serum bilirubin level, factors in prolonged jaundice and serum type IV collagen (7S domain) (7S) levels in 24 patients with obstructive jaundice due to various diseases. The mean value of 7S before the drainage operation in 24 patients was significantly higher than that in normal controls (p<0.001). There is no significant difference in value of 7S by sex or age, and the value was not influenced by differences either in location or duration of the obstruction. We divided 24 patients into 3 groups on the basis of the reduction rate "b", which were a "good group", b<-0.09; a "fair group", -0.09≤b<-0.05; and a "poor group", -0.05≤b. The mean value of 75 in the "poor group" was significantly higher than that in the "good group" (p<0.01), and the value of 7S was significantly correlated with the reduction rate "b" (p<0.01). The value of 7S in patients with positive bacterial cultures of the bile was higher than that in those with negative cultures (p<0.05). Furthermore, the white blood cell counts correlated well with the value of 7S (p<0.01). However we did not find the significant changes in the value of 7S after the drainage operation in each of the 3 groups. These results suggest that the value of 7S before the drainage operation is one of the factors in prolonged jaundice even after that is successfully carried out, under the influence of bile infection. Thus we concluded that the measurement of serum 7S domain level before the biliary decompression is clinically useful for predicting prolonged jaundice.

Key words
obstructive jaundice, type IV collagen (7s domain), prolonged jaundice, bile infection

Reprint requests
Noriyasu Komine The First Department of Surgery, National Defense Medical College
3-2 Namiki, Tokorozawa-shi, 359 JAPAN

Accepted
May 11, 1993

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