External biliary drainage plus bile acid feeding is not equal to internal drainage in preserving the cellular immunity following prolonged obstructive jaundice

This study investigates the importance of intestinal bile flow in cellular immunity. Sprague-Dawley rats undergoing bile duct ligation (BDL) and sham ceiliotomy (Sham) for 14 and 21 days were investigated. Experimental animal s following BDL were further divided into an external drainage (ED) group, an ED group with rat chow mixed with 2:2:1 cholic acid, chenodeoxycholic ac id, and deoxycholic acid ( ED + BF), and an internal drainage (1D) group. F ourteen days later, they were killed and analyzed for spleen lymphocytic [H -3] thymidine uptake (LHU) under mitogen stimulation with phytohemagglutini n, blood biochemistry, hemogram, and liver pathology. In the 14-day BDL exp eriment, LHU and serum albumin level were decreased in the BDL group (P < 0 .05). After drainage, they were not significantly different among sham, ED, ED + BF, and ID groups. In the 21-day BDL experiment, the red cell volume was decreased (P < 0.05). After drainage, the ED, ED + BF, and ID groups st ill had a significantly lower LHU than the sham group (P < 0.05). However, the ID group had higher LHU than the ED and ED + BF groups (P < 0.05). The ED + BF group had a slightly higher LHU than the ED group but not statistic ally significant. Liver pathology returned to normal after drainage in the 14-day BDL model. In contrast, the 21-day BDL group had prominent periporta l necrosis and developed periportal fibrosis after drainage. The present st udy reveals the duration of BDL determines the: severity of hepatic damage. In the 14-day BDL groups, all kinds of drainage completely reverse the imp aired liver function and cellular immunity. In the 21-day BDL group, 14-day drainage is inadequate for recovery because irreversible pathological chan ges are found. The; reversal of cellular immunity in ID is better and faste r, because it provides a better hepatic functional, nutritional, and hemato logical recovery besides the presence of primarily secreted bile acids.