Hepatic recovery after biliary drainage in experimental obstructive jaundice complicated by biliary infection.

The effects of an association of biliary infection and bile stasis on the recovery process of the impaired structure and function of the cholestatic liver after biliary drainage were studied in experimental animals. Obstructive jaundice was induced by clamping a tube inserted into the common bile duct of rats, while at the same time Escherichia coli bacteria were introduced into the tube to induce biliary infection. After one week, the biliary obstruction was removed. After 14 days of biliary drainage, the impaired structure and function of the cholestatic liver without biliary infection were remarkably improved, having returned almost to normal, while in the cases with biliary infection, the impairments were far less improved, especially with respect to mitochondrial function. These results suggest that major hepatic surgery should not be employed in patients with obstructive jaundice in the presence of biliary infection and should be delayed until hepatic function has recovered sufficiently after biliary drainage.