Liver histological, portal flow and plasmatic nitric oxide alterations caused by biliary obstruction and drainage in rats

Abstract

PURPOSE: To evaluate liver alterations caused by biliary obstruction and drainage. METHODS: Thirty-nine male Wistar rats were randomly distributed in 4 groups: BO (n=18) bile duct ligation for 20 days, with a periodic evaluation of liver histological alterations, Doppler echography portal flow and measurements of NO and malondialdehyde (MDA); BO/DB (n=13) bile duct occlusion for 20 days followed by biliary drainage by choledochoduodenal anastomosis, 5 days follow-up, same BO group parameters evaluations; group CED (n=4) sham operation and portal flow evaluation trough 20 days; CHB (n=4) sham operation, with hepatic biopsy on 25th day and followed-up trough 25 days, by the same parameters of group BO, with exception of portal flow. Direct bilirubin (DB) and alkaline phosphatase (AP) were evaluated in the group BO, BO/DB and CHB. RESULTS: The bile duct ligation led to an increase of DB and AP, development of liver histological alterations, reduction of portal flow and increase of plasmatic NO and of MDA levels. The bile duct clearing resulted in a reduction of DB, AP, NO, MDA histological alterations and increase of portal flow. CONCLUSION: The biliary occlusion resulted in cholestasis and portal flow reduction, besides the increase of plasmatic NO and of hepatic MDA levels, and histological liver alterations, with a tendency of normalization after the bile duct clearing.

Comparative study between ligature with thread or metallic clamping by means of laparoscopy with the purpose of experimental biliary obstruction in swines

“…However, in recent years, there was an increase in the diagnosis of asymptomatic lithiasis due to upgrading diagnostic methods routinely performed in patients [14][15][16][17] . Because of its frequency, many researchs are conducted to expand the knowledge about the pathogenesis and improving treatment of this disease 14,15,[18][19][20][21][22][23][24] . The treatment of biliary obstructions depends on the time between occurrence and diagnosis of the injury and, the type, extent and location of same in the bile ducts 14,25 , being the surgical treatment the most recommended 2,26 .…”

“…Assess any changes in liver and biliary tree due to biliary obstruction is of great importance, because it aids in clinical diagnosis of the patient, improving the quality and efficiency of treatment. For this, is required the development of experimental works, both to deepen knowledge of anatomy or in search for an ideal model for research as, also, for training and capacity of the surgeon to intervene surgically in the biliary tree 18,20,21,25,27,28,33 . In order to seek a physiological and anatomical reconstruction more suitable for extensive lesions of the biliary tree, was proposed a study of biliary reconstruction by interposing a conduit derived from a segment of small intestine, similar to the one that Monti and collaborators have proposed for urinary diversion with continence mechanisms 34,35 .…”