Kato S, Nagano I, Nimura Y, Wakabayashi T
First Department of Surgery, Nagoya University School of Medicine, Japan.
Hepatogastroenterology. 1994 Jun;41(3):217-21.
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.
在实验动物身上研究了胆道感染与胆汁淤积联合作用对胆汁引流后胆汁淤积性肝脏受损结构和功能恢复过程的影响。通过夹住插入大鼠胆总管的导管诱导梗阻性黄疸，同时将大肠杆菌引入导管以诱导胆道感染。一周后解除胆道梗阻。胆汁引流14天后，无胆道感染的胆汁淤积性肝脏受损结构和功能明显改善，几乎恢复正常，而在有胆道感染的病例中，损伤改善程度要小得多，尤其是线粒体功能方面。这些结果表明，在存在胆道感染的梗阻性黄疸患者中不应进行大的肝脏手术，而应推迟到胆汁引流后肝功能充分恢复。
