title: Cell biological evaluation of biliary drainage prior to hepatectomy in obstructive jaundice.
abstract: OBJECTIVE
  The necessity and efficacy of biliary drainage prior to major surgery in patients with obstructive jaundice have been reported in various clinical and experimental studies in Japan. However, it is not enough that Western countries understand the advantage of preoperative drainage. In this study, therefore, cytoprotective effect of preoperative biliary drainage drainage was evaluated using the cell biological technique.
  
  
  METHODS
  Ten jaundiced dogs and 10 with drainage (after induction of jaundice) were each divided into two groups: those with and those without 40% hepatectomy. Using these four groups, the advantage of biliary drainage before hepatectomy in obstructive jaundice was studied, using isolated hepatocytes and Kupffer cells.
  
  
  RESULTS
  In jaundiced dogs, isolated hepatocyte viability and intracellular cyclic AMP concentration were considerably reduced. The bleb formation rate, culture supernatant lipid peroxide and lactate dehydrogenase contents, and plasma thromboxane B2 and 6-keto-PGF1 alpha levels all markedly increased. These changes were more exaggerated in those after hepatectomy. In the dogs with drainage, all of these values were approximated to those in normal animals. The changes following hepatectomy in dogs with drainage were also less pronounced in comparison with jaundiced animals.
  
  
  CONCLUSIONS
  These findings suggest that biliary drainage prior to hepatectomy in obstructive jaundice mitigates liver impairment, both at the cellular level and in terms of prostanoid metabolism. It was concluded that preoperative biliary drainage prior to hepatectomy ensures better results for obstructive jaundice.
authors.affiliation: First Department of Surgery, Mie University School of Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ido
authors.forename: T
authors.initials: T
authors.lastname: Higashiguchi
authors.forename: K
authors.initials: K
authors.lastname: Tanigawa
authors.forename: Y
authors.initials: Y
authors.lastname: Kawarada
mesh_terms: D000818:Animals; D002470:Cell Survival; D002478:Cells, Cultured; D002779:Cholestasis / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D004285:Dogs; D004322:Drainage; D005260:Female; D006498:Hepatectomy; D007728:Kupffer Cells; D008099:Liver / Q000473:pathology*; D008111:Liver Function Tests; D008297:Male; D011300:Preoperative Care; D011453:Prostaglandins / Q000378:metabolism
chemical_list: D011453:Prostaglandins