ABSTRACT
Obstructive jaundice [OJ] can lead to hepatic and renal impairment. The aim of this study was to measure levels of serum Beta 2 Micro globulin [SB2M] in patients with OJ undergoing explorative surgery for relief of the obstruction and to determine the usefulness of such a measurement as a monitor for renal impairment relative to other measures of renal function. SB2M levels [mg/L] were not above the normal reference range preoperatively [2.39 [1.7-4.8]], intraoperatively [2.2[0.27-3.4], p = 0.08], six hours postoperatively [1.9 [1.03-4.8], p = 0.2] and after 24 hours [1.92 [0.95-4.9], p = 0.4] when compared to preoperative values. None of the patients involved in the study developed acute renal failure or suffered from severe renal or hepatic impairment preoperatively. Urea, creatinine and creatinine clearance [CrCl] perioperative changes were insignificant. Correlation between SB2M and CrCl was significant preoperatively [r = -0.41, p =0.02] but marginally failed to reach statistical significance postoperatively [r = -0.35, p = 0.053]. No significant correlation existed between SB2M and the following creatinine, urea, bilirubin and prothrombin time [PT]. Postoperative 24 hours PT was 12.87 [12-19.67] seconds, this was significantly lower than the preoperative PT 13.46 [12-26] seconds [p = 0.001]. No blood products were used during surgery. OJ was not associated with an increase in serum B2M blood levels. Severe renal failure was not encountered due to stability of the haemodynamic parameters and the guided fluid therapy. Few patients showed some degree of renal dysfunction but this did not develop to failure. This study cannot recommend the routine measurement of SB2M, as it did not add to the existing routine renal function tests. Improvement in PT after relief of OJ indicates the need for an early surgical intervention