Abstract
The aims of this study were (1) to investigate the effect of experimental obstructive jaundice on the healing of intestinal anastomosis, and (2) to investigate the effect of pentoxifylline on the healing of intestinal anastomosis in rats with obstructive jaundice. Obstructive jaundice was induced in rats by the ligation and division of the common bile duct. Four days after this operation, either pentoxifylline or isotonic saline solution was administered intraperitoneally to these jaundiced rats and controls, and then intestinal anastomosis was performed. The concentrations of serum tumor necrosis factor α (TNF-α) and serum triglyceride of jaundiced and nonjaundiced rats were measured, and the quality of healing was evaluated by measuring the bursting preasure and hydroxyproline content of the anastomoses on the fifth and tenth days of anastomotic healing. Obstructive jaundice resulted in an impaired wound healing of the intestinal anastomosis in the rats. The administration of pentoxifylline to the jaundiced rats resulted in better anastomotic wound healing. The beneficial effects of pentoxifylline on anastomotic healing in rats with obstructive jaundice was attributed to its inhibitor effect on the endotoxin-induced TNF-α release from macrophages and monocytes, and the stabilizing effect on the neutrophils.
Similar content being viewed by others
References
Dawson JL (1968) Acute postoperative renal failure in obstructive jaundice. Ann R Coll Surg Engl 42:163–181
Dawson JL (1970) Surgical aspects of jaundice. B Med J 1:228–230
Pain JA, Cahill CJ, Bailey ME (1985) Perioperative complications in obstructive jaundice: therapeutic considerations. Br J Surg 72:942–945
Wait RB, Kahng KU (1989) Renal failure complicating obstructive jaundice. Am J Surg 157:256–263
Armstrong CP, Dixon JM, Taylor TV, Davies GC (1984) Surgical experience of deeply jaundiced patients with bile duct obstruction. Br J Surg 71:234–238
Dixon JM, Armstrong CP, Duffy SW, Dawies GC (1983) Factors affecting morbidity and mortality after surgery for obstructive jaundice: a review of 373 patients. Gut 24:845–852
Blamey SL, Fearon KCH, Gilmour WH, Osbourne DH, Carter DC (1983) Prediction of risk in biliary surgery. Br J Surg 70:535–538
Irwin TT, Vassilakis JS, Chattopadhyay DK, Greaney MG (1978) Abdominal wound healing in jaundiced patients. Br J Surg 65: 521–522
Armstrong CP, Dixon JM, Duffy SW, Elton RA, Davies GC (1984) Wound healing in obstructive jaundice. Br J Surg 71:267–270
Bayer I, Ellis H (1976) Jaundice and wound healing; an experimental study. Br J Surg 63:392–396
Arnaud JP, Humbert W, Eloy MR (1981) Effect of obstructive jaundice on wound healing. Am J Surg 141:593–596
Askew AR, Bates GJ, Balderson G (1984) Jaundice and the effect of sodium taurocholate taken orally upon abdominal wound healing. Surg Gynecol Obstet 159:207–209
Lee E (1972) The effect of obstructive jaundice on the migration of reticulo-endothelial cells and fibroblasts into early experimental granulomata. Br J Surg 59:875–877
Pain JA, Bailey ME (1987) Measurement of operative plasma endotoxin levels in jaundiced and non-jaundiced patients. Eur Surg Res 19:207–216
Greve JWM, Gouma DJ, Buurman WA (1992) Complications in obstructive jaundice: role of endotoxins. Scand J Gastroenterol 27 (Suppl):194:8–12
Bailey ME (1976) Endotoxin, bile salts and renal function in obstructive jaundice. Br J Surg 63:744–778
Drivas G, James O, Wardle N (1976) Study of reticuloendothelial phagocytic capacity in patients with cholestasis. Br Med J 1:1568–1569
Liehr H, Englisch G, Rasenack U (1980) Lactulose—a drug with antiendotoxin effect. Hepato-gastroenterology 27:356–360
Evans JR, Torrealba V, Hudd C, Knight M (1982) The effect of preoperative bile salt administration on postoperative renal function in patients with obstructive jaundice. Br J Surg 69:706–708
Kelker HC, Oppenheim JD, Stone-Wolff D, Henriksen-SeStefano D, Aggarwal BB, Stevenson HC, Vilček J (1985) Characterization of human tumor necrosis factor produced by peripheral blood monocytes and its separation from lymphotoxin. Int J Cancer 36:69–72
Männel DN, Moore RN, Mergenhagen SE (1980) Macrophages as a source tumoricidal activity (tumor necrosis factor). Infect Immun 30:523–526
Tracey KJ, Beytler B, Lowry SF, Merryweather J, Wolpe S, Milsark IW, Hariri RJ, Fahey TJ III, Zentella A, Albert JD, Shires GT, Cerami A (1986) Shock and tissue injury induced by recombinant human cachectin. Science 234:470–474
Beutler B, Cerami A (1987) Cachectin: more than a tumor necrosis factor. N Engl J Med 316:379–385
Schilling JA (1976) Wound healing. Surg Clin North Am 56:859
Witte MB, Barbul A (1997) General principles of wound healing. Surg Clin North Am 77:509–528
Thornton FJ, Barbul A (1997) Healing in the gastrointestinal tract. Surg Clin North Am 77:549–573
Sayan M, Alponat A, Yavuz N, Altinkaya E, Gösel S, Sariyar M (1997) The effect of oral sodium taurocholate on endotoxemia and intestinal anastomotic wound healing in rats with obstructive jaundice. Surg Today 27:953–957
Jamall IS, Finelli VN, Que Hee SS (1981) A simple method to determine nanogram levels of 4 hydroxyproline in biological tissues. Ann Biochem 112:70–75
Hendriks T, Mastboom WJB (1990) Healing of experimental intestinal anastomoses: parameters for repair. Dis Colon Rectum 33:891–901
Nasution AF, Taylor DE (1981) The effect of acute haemorrhage and of delayed blood replacement on wound healing: an experimental study. Br J Surg 68:306–309
Madden JW, Peacock EE Jr (1968) Studies on the biology of collagen during wound healing. Surgery 64:288–294
Wilkinson SP, Moody H, Stamatakis JD, Kakkar VV, Williams R (1976) Endotoxaemia and renal failure in cirrhosis and obstructive jaundice. Br Med J 2:1415–1418
Cahill CJ, Pain JA, Bailey ME (1987) Bile salts, endotoxin and renal function in obstructive jaundice. Surg Gynecol Obstet 165:519–522
Beutler B, Milsark IW, Cerami A (1985) Cachectin/tumor necrosis factor; production, distribution, and metabolic fate in vivo. J Immunol 135:3972–3977
Michie HR, Manouge KR, Spriggs DR, Reevhaug A, O’Dwyer SO, Dinarello CA, Cerami A, Wolff SM, Wilmore DW (1988) Detection of circulating tumor necrosis factor after endotoxin administration. N Engl J Med 318:1481–1486
Gamble JR, Harlan JM, Klebanoff SJ, Vadas MA (1985) Stimulation of the adherence of neutrophils to umblical vein endothelium by human recombinant tumor necrosis factor. Proc Natl Acad Sci USA 82:8667–8671
Tsujimoto M, Yokota S, Vilc<ek J, Weissmann G (1986) Tumor necrosis factor provokes superoxide anion generation from neutrophils. Biochem Biophys Res Commun 137:1094–1100
Klebanoff SJ, Vadas MA, Harlan JM, Sparks LH, Gamble JR, Agosti JM, Waltersdorph AM (1986) Stimulation of neutrophils by tumor necrosis factor. J Immunol 136:4220–4226
Solis-Herruzo JA, Brenner DA, Chojkier M (1988) Tumor necrosis factor α inhibits collagen gene transcription and collagene synthesis in cultured human fibroblasts. J Biol Chem 263:5841
Dinarello CA, Cannon JG, Wolf SM (1986) Tumor necrosis factor (cachectin) is an endogenous pyrogen and induces production of interleukin 1. J Exp Med 163:1433
Dayer JM, Zavadil-Grob C, Ucla C, Mach B (1984) Induction of human interleukin 1 mRNA measured by collagenase- and prostoglandin-E2-stimulating activity in rheumatoid synovial cells. Eur J Immunol 14:898
Dayer JM, Beutler B, Cerami A (1985) Cachectin/tumor necrosis factor stimulates collagenase and prostaglandin E2 production by human synovial cells and fibroblasts. J Exp Med 162:2153–2157
Bevilacqua MP, Pober JS, Majeau GR, Fiers W, Cotran RS, Gimbrone MA (1986) Recombinant tumor necrosis factor induces procoagulant activity in cultured human vascular endothelium: characterization and comparison with the actions of interleukin 1. Proc Natl Acad Sci USA 83:4533
Nawroth PP, Stern DM (1986) Modulation of endothelial cell hemostatic properties by tumor necrosis factor. J Exp Med 163:740–744
Fràter-Schröder M, Risau W, Hallmann R, Gautschi P, Böhlen P (1987) Tumor necrosis factor type α, a potent inhibitor of endothelial cell growth in vitro, is angiogenic in vivo. Proc Natl Acad Sci USA 84:5277–5281
Ford HR, Hoffman RA, Wing EJ, Magee DM, McIntyre L, Simmons RL (1989) Characterization of wound cytokines in the sponge matrix model. Arch Surg 124:1422–1428
Bemelmans MHA, Gouma DJ, Greve JW, Buurman WA (1992) Cytokines tumor necrosis factor and interleukin-6 in experimental biliary obstruction in mice. Hepatology 15:1132–1136
Beutler B, Mahony J, Le Trang N, Pekala P, Cerami A (1985) Purification of cachectin, a lipoprotein lipase-suppressing hormone secreted by endotoxin induced raw 264.7 cells. J Exp Med 161:984–995
Fiengold KR, Serio MK, Adi S (1989) Tumor necrosis factor stimulates hepatic lipid synthesis and secretion. Endocrinology 124:2336–2342
Greve JW, Maessen JG, Tiebosch T, Buurman WA, Gouma DJ (1990) Prevention of postoperative complications in jaundiced rats. Ann Surg 212:221–227
Strieter RM, Remick DG, Ward PA, Spengler RN, Lynch JP, Larrick J, Kunkel SL (1988) Cellular and molecular regulation of tumor necrosis factor-alpha production by pentoxifylline. Biochem Biophys Res Commun 155:1230–1236
Waage A, Sørensen M, Størdal B (1990) Differential effect of oxpentifylline on tumor necrosis factor and interleukin-6 production. Lancet 335:543
Schade FU (1990) Pentoxifylline increases survival in murine endotoxin shock and decreases TNF formation. Circ Shock 31:171–181
Zabel P, Wolter DT, Schönharting MM, Schade UF (1989) Oxpentifylline in endotoxaemia. Lancet 1:1474–1477
Mandell GL (1988) ARDS, neutrophils, and pentoxifylline. Am Rev Respir Dis 138:1103–1105
Bessler H, Gilgal R, Djalderti M, Zahavi I (1986) Effect of pentoxifylline on the phagocytotic activity, cAMP levels, and superoxide anion production by monocytes and polymorphonuclear cells. J Leukocyte Biol 40:747–754
Sullivan GW, Carper HT, Novick WJ, Mandell GL (1988) Inhibition of the inflammatory action of interleukin 1 and tumor necrosis factor (alpha) on neutrophil function by pentoxifylline. Infect Immun 56:1722–1729
Schönharting MM, Shade FU (1989) The effect of pentoxifylline in septic shock—new pharmachologic aspects of an established drug. J Med 20:97
Welsh CH, Lein D, Worthen GS, Weil JW (1988) Pentoxifylline decreases endotoxin-induced pulmonary neutrophil sequestration and extravascular protein accumulation in the dog. Am Rev Respir 138:1106–1114
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cömert, M., Taneri, F., Tekin, E. et al. The effect of pentoxifylline on the healing of intestinal anastomosis in rats with experimental obstructive jaundice. Surg Today 30, 896–902 (2000). https://doi.org/10.1007/s005950070041
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s005950070041