CELL BIOLOGICAL EVALUATION OF BILIARY DRAINAGE PRIOR TO HEPATECTOMY IN OBSTRUCTIVE-JAUNDICE

Background/Aims: The necessity and efficacy of biliary drainage prior to major surgery in patients with obstructive jaundice have been repor ted in various clinical and experimental studies in Japan. However, it is not enough that Western countries understand the advantage of preo perative drainage. In this study, therefore, cytoprotective effect of preoperative biliary drainage was evaluated, using the cell biological technique. Materials and Methods: Ten jaundiced dogs and 10 with drai nage (after induction ofjaundice) were each divided into two groups: t hose with and those without 40% hepatectomy. Using these four groups, the advantage of biliary drainage before hepatectomy in obstructive ja undice was studied, using isolated hepatocytes and Kupffer cells. Resu lts: In jaundiced dogs, isolated hepatocyte viability and intracellula r cyclic AIWP concentration were considerably reduced. The bleb format ion rate, culture supernatant lipid peroxide and lactate dehydrogenase contents, and plasma thromboxane B-2 and 6-keto-PGF1 alpha levels all markedly in B creased. These changes were more exaggerated in those a fter hepatectomy. In the dogs with drainage, all of these values were approximated to those in normal animals. The changes following hepatec tomy in dogs with drainage were also less pronounced in comparison wit h 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 meta bolism. It was concluded that preoperative biliary drainage prior to h epatectomy ensures better results for obstructive jaundice.