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Year : 2013  |  Volume : 5  |  Issue : 9  |  Page : 523-528

A comparative analysis of nasogastric and intravenous fluid resuscitation in patients with malignant obstructive jaundice prior to endoscopic biliary drainage

1 Department of Surgical Gastroenterology, King George's Medical University, Lucknow, India
2 Physical Medicine and Rehabilitation Center, King George's Medical University, Lucknow, India

Correspondence Address:
Rajeshwar Nath Srivastava
Department of Physical Medicine and Rehabilitation Center, King George's Medical University, Lucknow - 226 003, Uttar Pradesh
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Source of Support: Council of Science and Technology, UP, Govt. of Uttar Pradesh, Lucknow, India., Conflict of Interest: None

DOI: 10.4103/1947-2714.118932

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Background: An alternative to intravenous is nasogastric fluid administration through normal functioning gut. Though not common, this practice has significance in mass causalities and elective situations. Aim: The study was designed to compare nasogastric and intravenous fluid resuscitation in malignant obstructive jaundice (OJ) and their effect on endotoxemia. Materials and Methods: Sixty patients with malignant OJ undergoing endoscopic biliary drainage were randomized into two groups. A total of 4 l of fluid (Ringer's lactate) was administered to Group A through nasogastric tube and to Group B through intravenous route for 48 h. Vital parameters, serum bilirubin, serum creatinine, creatinine clearance rate, electrolytes, and endotoxemia were monitored. Results: Significant improvement in blood pressure (Group A, P = 0.014; Group B, P = 0.020) and significant decrease in serum bilirubin level (Group A, P = 0.001; Group B, P < 0.0001) was observed in both groups after resuscitation. Significantly decreased (P = 0.036) post hydration endotoxin level was observed in Group A as compared to Group B. Febrile events were significantly higher (P = 0.023) in Group B as compared to Group A (6 vs 0). Electrolyte abnormalities were found more in Group B, however statistically insignificant. Conclusion: In OJ patient undergoing biliary drainage, preoperative fluid resuscitation through nasogastric tube may be helpful in reducing postoperative septic complications and endotoxemia.

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