[Pathophysiology of obstructive jaundice and its surgical problems].
Mitochondrial respiratory function, ketogenesis, collagen metabolism of the liver in rats, dogs and patients with obstructive jaundice were investigated. In animal experiments, it was revealed that mitochondrial respiratory function and ketogenesis decreased significantly with prolongation of biliary obstruction. Hepatic collagen content and its synthesis significantly increased in biliary obstruction. After relief of biliary obstruction in these dogs and patients, these functions and contents improved or returned to near normal levels according to the duration of biliary obstruction and period after relief. By steroid hormone and CoQ administration to jaundiced rats, improvement of mitochondrial function was obtained to some extent. Cross circulation between the jaundiced rat and normal one was performed and it was found that mitochondrial function in normal rat was decreased and that of jaundiced rat improved, especially in renal mitochondria. When major surgery is required in patients of biliary obstruction with severe jaundice, biliary drainage should be carried out first 4 to 6 weeks before major operation. Steroid or CoQ therapy and plasma exchange are also useful for these patients.
D000818:Animals; D002779:Cholestasis / Q000503:physiopathology* / Q000601:surgery; D004285:Dogs; D006801:Humans; D051381:Rats