Baumgartner Ulrich, Schölmerich Jürgen, Feuerstein Elisabeth, Baier Peter, Ihling Christian
Department of Surgery, University of Freiburg, Freiburg, Germany.
J Surg Res. 2003 Mar;110(1):222-7. doi: 10.1016/s0022-4804(02)00082-3.
Long-term bile duct obstruction causes sinusoidal regurgitation of bile acids, a shift in bile acid metabolism, and alterations of liver histology. In this study we investigated the regurgitation of bile acids during short-term bile duct obstruction and its reversibility and reproducibility. In addition, the biotransformation of taurodeoxycholate and its appearance in bile and perfusate effluent were studied as well as liver histology.
Rat livers (n = 5) were perfused in vitro with 32 nmol/min/g liver taurodeoxycholate over 85 min with the bile duct being intermittently closed for 30 and 20 min, respectively.
Within the first 5 min after bile duct obstruction bile acids started to regurgitate to the perfusate effluent amounting to approximately 15% of hepatic uptake until the end of the perfusion period. After relief of obstruction, bile flow and biliary bile acid excretion showed an overshoot phenomenon and were almost doubled compared to preobstruction. In contrast, sinusoidal bile acid regurgitation declined. The same phenomenon was observed during the second closure/opening cycle of the bile duct. Regurgitated bile acids consisted of significantly more taurodeoxycholate metabolites (approximately 70%) than did biliary bile acids (approximately 30%). Histology of liver parenchyma was preserved.
During repetitive short-term bile duct obstruction bile acid regurgitation is reversible and reproducible. The absence of altered mechanical barriers suggests that specific pathways are involved in the regurgitation process of bile acids.
长期胆管梗阻会导致胆汁酸的窦状反流、胆汁酸代谢改变以及肝脏组织学变化。在本研究中,我们调查了短期胆管梗阻期间胆汁酸的反流情况及其可逆性和可重复性。此外,还研究了牛磺脱氧胆酸盐的生物转化及其在胆汁和灌注流出液中的出现情况以及肝脏组织学。
用32 nmol/min/g肝脏的牛磺脱氧胆酸盐对大鼠肝脏(n = 5)进行体外灌注85分钟,期间胆管分别间歇性闭合30分钟和20分钟。
在胆管梗阻后的最初5分钟内,胆汁酸开始反流至灌注流出液,直至灌注期结束时,反流的胆汁酸量约占肝脏摄取量的15%。梗阻解除后,胆汁流量和胆汁中胆汁酸排泄出现过冲现象,与梗阻前相比几乎增加了一倍。相比之下,窦状隙胆汁酸反流减少。在胆管的第二次闭合/开放周期中也观察到了相同的现象。反流的胆汁酸中牛磺脱氧胆酸盐代谢物(约70%)的比例明显高于胆汁中的胆汁酸(约30%)。肝实质的组织学结构得以保留。
在重复性短期胆管梗阻期间,胆汁酸反流是可逆且可重复的。机械屏障未改变表明胆汁酸反流过程涉及特定途径。