[The pathomorphology of the liver after unilateral hepatic duct obstruction with laboratory-chemical observations of the course in the dog].

UNLABELLED

In an experimental study the morphological and functional changes of the liver with unilateral hepatic duct obstruction were investigated over a period of 13 months. In 4 series different parts of the liver were excluded of the bile drainage by hepatic duct ligation after cholecystectomy (group I = 25%, group II = 50%, group III 75%, group IV = 100% of the liver, series V = control group was cholecystectomy only. The clinical outcome, biochemical parameters, liver biopsy were examined regularly. Bacteriologic investigation of the bile and hepatic flow measurement were performed at the beginning and at the end of the study.

RESULTS

The clinical symptoms were discrete and the biochemical parameters showed a typical course. After 6 weeks, atrophy of the excluded liver with contralateral compensatoric hypertrophy was found. The microscopic correlation was the secondary sclerosing cholangitis (SSC). After 6 weeks, a concentric periductal fibrosis was to be observed in the periportal area. After 12 weeks, bile duct vanishing with persistence of the arteries and veins was found. After 36-48 weeks, biliary cirrhosis and total destruction of the liver parenchyma was found respectively. Simultaneously a chronic disturbance of the hepatic perfusion was seen. It was caused by a perivenous fibrosis of the terminal vein with obliteration of the lumen by endangiitic proliferations and cavernous transformation. The genesis of SSC seemed not be be influenced by bile contamination. The ligated as well as the unligated bile ducts were infected in 20-50% only. There was no difference in the liver specimens with sterile or contaminated bile. The hepatic flow measurement showed a reduction of the portal blood flow and a rise of the arterial flow depending on the amount of the excluded liver. A better understanding of the pathophysiological sequelae of the unilateral hepatic duct obstruction suggests that the drainage by surgical or radiological methods may not invariably be necessary.