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S-adenosyl-L-methionine in the treatment of obstructive jaundice after surgical drainage:a randomized multicenter trial

Objective To study the effect f S-adenosyl-L-methionine(SAMe)on the clinical symptoms,signs and the liver functions in patients receiving biliary drainage for obstructive jaundice. Methods A randomized prospective multicenter clinical trial was designed in patients with obstructive jaundice.The enrolled criteria were obstructive jaundice,preoperative serum total bilirubin level34. 2mmol/L,and without evidence of liver cirrhosis and hepatitis.A total of 90 patients were included in the study.The degrees of pruritus,fatigue,anorexia,abdominal distension,jaundice,and the colors of urine and stool before and after the operations were recorded.Serum levels of bilirubin and liver en- zymes were also determined.Results Ten days treatment with SAMe could reduce the levels of pruri- tus,fatigue,anorexia and abdominal distension.The levels of serum total bilirubin,direct bilirubin, τ-glutamyl transpeptidase and alkaline phosphatase were reduced more markedly than the control group,and serum levels of total protein and albumin were slightly elevated.Conclusions Twice daily intravenous infusion of 0.5g of SAMe to patients with obstructive jaundice after surgical drainage of the biliary tract could improve the clinical symptoms,signs,and promote the decrease of serum biliru- bin and liver enzymes,which was beneficial to the patients recovery.