Initial site of bile regurgitation following extrahepatic biliary obstruction in living rats.
OBJECTIVE
The precise mechanism of bile regurgitation from the biliary system to the blood stream still remains to be elucidated. The aim of this study was to examine the initial site of bile regurgitation in vivo after common bile duct (CBD) obstruction by digitally enhanced fluorescence microscopy.


METHODS
The fluorescence excreted into bile canaliculi after the administration of sodium fluorescein was continuously observed in CBD obstruction, using video-enhanced contrast (VEC) microscopy equipped with a silicon intensified target (SIT) camera. The liver histology and the localization of Mg(2+)-ATPase were examined by light and electron microscopy.


RESULTS
By the continuous recording of canalicular fluorescence, the sequential regurgitation of the fluorescence from the canaliculi to the hepatocyte cytoplasm to the sinusoids was distinctively recognized after CBD obstruction. Bile canalicular fluorescence was enhanced, and then the fluorescence of the hepatocyte cytoplasm increased in intensity, followed by regurgitation of the fluorescence to the sinusoids. These in vivo sequences closely correlated with changes in CBD pressure. In zone 1, canalicular fluorescence focally burst into hepatocyte cytoplasm, thus resulting in the formation of fluorescent cells. By light and electron microscopy, the fluorescent cells were found to correspond to the liver cell injury. The reaction products of Mg(2+)-ATPase were incorporated into vesicles with a decreased canalicular activity, and then were transported to the sinusoidal surface after CBD obstruction.


CONCLUSIONS
The initial site of bile regurgitation may be transcellular, and partly involves liver cell injury in zone 1 in extrahepatic biliary obstruction, associated with increased pressure of the biliary system.
Watanabe
Norihito
N
Division of Gastroenterology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan. norihito@is.icc.u-tokai.ac.jp
Kojima
Sei-ichiro
S
Takashimizu
Shinji
S
Nishizaki
Yasuhiro
Y
Kagawa
Tatehiro
T
Phillips
M James
MJ
D000818:Animals; D001646:Bile / Q000378:metabolism*; D001648:Bile Canaliculi / Q000201:enzymology / Q000378:metabolism* / Q000648:ultrastructure; D001808:Blood Vessels / Q000378:metabolism; D017301:Ca(2+) Mg(2+)-ATPase / Q000378:metabolism; D001651:Cholestasis, Extrahepatic / Q000097:blood / Q000378:metabolism* / Q000473:pathology; D003593:Cytoplasm / Q000378:metabolism; D004195:Disease Models, Animal; D005260:Female; D019793:Fluorescein; D005456:Fluorescent Dyes; D022781:Hepatocytes / Q000378:metabolism; D008099:Liver / Q000378:metabolism* / Q000648:ultrastructure; D008854:Microscopy, Electron; D008856:Microscopy, Fluorescence; D018715:Microscopy, Video / Q000379:methods*; D051381:Rats; D017208:Rats, Wistar; D012815:Signal Processing, Computer-Assisted; D013997:Time Factors
D005456:Fluorescent Dyes; D017301:Ca(2+) Mg(2+)-ATPase; D019793:Fluorescein