Patients with jaundice due to extrahepatic biliary ob-struction still experience a high rate of
postoperative complications and death. Many complications are infectious in nature or
related to defects in host defense, and others are systemic. Because of the known cytotoxic-
ity of bile salts and the suspected toxicity of high levels of intracellular bilirubin, both are
suspected as media-tors of some of the systemic consequences of obstructive jaundice.
Recent data suggest that. nnore complex mecha-nisms involving changes in gut flora and …