J.Jpn. Surg. Soc.. 80(9): 820-827, 1979

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Original article

EFFECT OF THE BILIARY DRAINAGE ON THE LIVER WITH OBSTRUCTIVE JAUNDICE
―Experimental and Clinical Studies on the Mitochondrial Respiration and Collagen Metabolism of the Liver―

Changes of hepatic functions such as mitochondrial respiration, ketogenesis, hepatic collagen and standard liver function tests before and after relief of the bile duct obstruction were investigated in both experimental dog model and clinical cases with periampullary carcinoma.
In experimental studies, mitochondrial respiratory functions clearly recovered in 3 weeks after relief of biliary obstruction in a group with shortterm biliary obstruction, whereas slight recovery was observed 7 weeks after release of long term biliary obstruction. Ketogenesis, which reduced markedly after biliary obstruction, recovered slightly only in a group with short-term obstruction. Hepatic collagen which increased after biliary obstruction substantially decreased by release of the obstruction reteurning to control values in cases with short-term obstruction. Studies on clinical cases showed almost similar tendencies to experimental studies.
Recovery from hepatic dysfunction after release of biliary obstruction depended strongly upon the duration of obstruction. Therefore, biliary drainage should be initially performed, followed by radical operation at an intervals of 4 or 6 weeks, and in cases with long-term obstruction, interval should be more than 6 weeks, because recovery of hepatic function after biliary drainage is extremely slow.

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