Koyama K, Takagi Y, Ito K, Sato T
Am J Surg. 1981 Aug;142(2):293-9. doi: 10.1016/0002-9610(81)90296-8.
Mitochondrial respiratory function, ketogenesis and collagen metabolism of the liver in biliary obstruction and after its relief were investigated in dogs and patients with obstructive jaundice. In dogs, it was found that hepatic mitochondrial respiratory function decreased significantly with prolongation of biliary obstruction, but recovered to varying degrees depending on both the duration of obstruction and of the period after the relief of obstruction. Ketogenesis was also impaired by biliary obstruction and its recovery was found in a slight degree only in cases with short-term obstruction. Hepatic collagen content and the synthetic ability significantly increased in biliary obstruction, and returned to normal levels with a relatively short period after the relief. Analogous results were obtained in clinical cases, but the decrease in serum bilirubin was somewhat delayed and increased hepatic collagen content continued after relief of the obstruction. When major surgery is required in patients with obstructive jaundice, biliary drainage should be carried out first 4 to 6 weeks before the performance of major operations. In cases with biliary obstruction for 12 weeks or more, it is desirable to wait for more than 6 weeks after biliary drainage since recovery of hepatic function, especially mitochondrial function, will be extremely slow.
在犬类和梗阻性黄疸患者中，研究了胆道梗阻及其解除后肝脏的线粒体呼吸功能、生酮作用和胶原代谢。在犬类中发现，随着胆道梗阻时间的延长，肝脏线粒体呼吸功能显著下降，但根据梗阻持续时间和梗阻解除后的时间段不同，其恢复程度各异。生酮作用也因胆道梗阻而受损，仅在短期梗阻的病例中发现有轻微恢复。胆道梗阻时肝脏胶原含量和合成能力显著增加，梗阻解除后在相对较短的时间内恢复到正常水平。临床病例也得到了类似结果，但血清胆红素的下降有所延迟，梗阻解除后肝脏胶原含量持续增加。对于梗阻性黄疸患者，如果需要进行大手术，应在进行大手术前4至6周先进行胆道引流。在胆道梗阻12周或更长时间的病例中，由于肝功能尤其是线粒体功能的恢复极其缓慢，可以在胆道引流后等待6周以上。
