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Treatment of jaundice
Last reviewed: 04.07.2025
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Jaundice itself, especially that caused by an increase in direct bilirubin, is not the object of therapeutic measures. On the contrary, indirect bilirubin, being a fat-soluble compound, can have a damaging effect on some structures of the nervous system with a high lipid content. It can manifest itself at a concentration of indirect bilirubin in the blood serum over 257-340 μmol/l. In premature infants, with hypoalbuminemia, acidosis, and the administration of a number of drugs that compete in the blood for a bond with albumin (sulfonamides, salicylates), bilirubin has a damaging effect even at a lower concentration. Treatment of jaundice, or rather measures aimed at reducing the intensity of jaundice, is usually carried out only in newborns and young children with a high content of unconjugated bilirubin in the blood serum (Crigler-Najjar syndrome, etc.). In acute viral hepatitis, the basis of treatment is basic therapy: diet, physical rest and detoxification therapy. Currently, in the case of fulminant HBV and AGS, it is recommended to prescribe antiviral therapy.
Extrahepatic obstruction of the bile ducts usually requires surgical intervention: endoscopic removal of stones from the ducts, placement of stents and drainage catheters in case of stenosis. In case of inoperable obstruction, for example, due to a tumor of the pancreas, the ampulla of Vater, as a palliative measure, the bile ducts are usually drained using stents inserted transhepatically or endoscopically. Currently, endoscopic papillotomy with stone extraction has replaced laparotomy in patients with stones in the common bile duct.
In case of intrahepatic cholestasis (cholestatic form of viral hepatitis), ursodeoxycholic acid preparations are prescribed and plasmapheresis sessions are performed.