Transport and conjugation of 14C-bilirubin during acute and chronic cholestasis in the cholecystectomized dog.

The role of the lymphatics in the regurgitation of bilirubin during acute and chronic extrahepatic cholestasis in the dog was studied after intravenous injection of 14C-bilirubin. In acute cholestasis the injected labelled bilirubin was rapidly removed from plasma and reappeared in thoracic duct lymph as labelled bilirubin conjugates. No labelled conjugates were at any time demonstrated in plasma. This is most easily explained as a result of a bilio-lymphatic regurgitation. In chronic cholestasis the labelled bilirubin conjugates were delivered back into the blood, and no specific transport function of the lymph was found. Our results indicate a change in liver cell secretory direction in long-standing cholestasis.