New Strategies for Preventing/Treating Postoperative Ileus

Gut-Liver Immunopharmacology Unit


Project 6

New Strategies for Preventing/Treating Postoperative Ileus


After abdominal surgery, gastrointestinal motility is impaired. This postoperative ileus (POI) usually resolves within 3 days but can become prolonged with severe nausea and vomiting and prolonged hospital stay. The pathogenesis of POI is multifactorial with an iatrogenic component due to perioperative medicines, most importantly opioid analgesics. In the gut, an inflammatory cascade is triggered by resident macrophages in the muscular layer, that are activated during the manipulation of the gut. Cytokines, chemokines and adhesion molecules are expressed and circulatory leukocytes are recruited to the manipulated gut wall. Nitric oxide and prostaglandins released by the inflammatory cells inhibit gastrointestinal motility. The actually used fast-track protocols and medicines do not at all fully prevent the occurrence of prolonged POI. The manipulation-induced inflammation is now considered as primary target for preventive/therapeutic strategies. This project explores new strategies to prevent/interfere with postoperative gut inflammation for prevention/therapy of POI in a murine model.


Romain Lefebvre