No Significant Effect Of Daikenchuto (Tj-100) On Peritoneal Il-9 And Ifn-Gamma Levels After Pancreaticoduodenectomy

Aim and Background: TJ-100 is a traditional Japanese medicine that affects inflammation and gastrointestinal motility, and is used as a preventive and treatment for paralytic ileus. This study aims at determining the effect of TJ-100 on the peritoneal levels of IFN-gamma/IL-9, cytokines related to ileus, after pancreaticoduodenectomy (PD) in a clinical setting.Methods: This was a subsidiary study of the clinical trial investigating the effect of TJ-100 on postoperative bowel function. Ascites was collected from 180 patients using an abdominal drainage tube on postoperative day 1 and 3 after PD (POD 1 or POD 3) and used to measure 27 cytokines. We performed univariate and multivariate analyses using several perioperative variables and administration of TJ-100/placebo to determine the effect of TJ-100 on the levels of IFN-gamma and IL-9.Results: Peritoneal levels of IL-9 and IFN-gamma decreased between POD 1 and 3 (Wilcoxon signed-rank test p<0.001). Multivariate analysis was performed after univariate analysis to select the variables and patients with a body mass index of >= 22 kg/m(2), older age, use of epidural anesthesia, and longer surgery correlated with the levels of IL-9 and IFN-gamma. However, we could not detect a correlation between the use of TJ-100 and cytokine levels in ascites either on POD 1 or 3.Conclusion: TJ-100 did not affect peritoneal IL-9 and IFN-gamma levels after PD. This was in accordance with published clinical findings showing no improvement in bowel function after PD and TJ-100 treatment.