Metabolic Alterations in Obstructive Jaundice: Effect of Duration of Jaundice and Bile‐Duct Decompression

Abstract

We examined the effect of prolonged bile duct obstruction, and subsequent biliary decompression, on biochemical and metabolic parameters, using a reversible jaundice model in male Fischer 344 rats. The animals were studied after biliary obstruction for varying periods (4 days, one week, and two weeks) and following decompression. They were sacrificed one or two weeks following decompression. All the rats were compared to sham operated, pair-fed, controls. Obstructive jaundice rapidly increased bilirubin, liver enzymes, serum free fatty acid, and triglyceride levels. Glucose levels were significantly decreased in the jaundice rats compared to their pair-fed controls. Only after two weeks of jaundice was significant hypoalbuminemia observed. Following decompression, all biochemical and metabolic values gradually returned to normal levels, except for albumin. Hypoalbuminemia was not reversed within the two-week post-decompression period. The rats jaundiced for two weeks had significantly higher mortality, compared to the other groups. We conclude that prolonged jaundice adversely affects the metabolic capacity of the rats, with albumin concentration being markedly decreased, and that biliary decompression could not reverse completely all the alterations seen with cholestasis, especially following two weeks of bile duct obstruction.

Restoration of hepatocytes function following decompression therapy in extrahepatic biliary obstructed patients: Metabolite profiling of bile by NMR

“…The results on clinical data in our study clearly show a trend of liver function tests, bilirubin levels and parameters of cholangitis returning towards normalization (reached an optimal value) after one week following decompression which are in accordance to various animal and human studies [18][19][20][21]39]. The greenish colour of bile in majority of the patients following one week of drainage further indicates alleviation in the severity of jaundice.…”

“…Biliary drainage via PTBD alleviates icterus, resolves infection, restores most of the changes of the liver parenchyma and recovery of tight junction of hepatocytes and immune function [5][6][7]16,17]. It improves liver reserve function, nutritional and energy status [18][19][20][21] and reduces postoperative mortality [6]; patients with tumor could have more chances to receive chemotherapy/ radiotherapy/photodynamic therapy/radiofrequency ablation [22]. Drainage has been shown to improve prognosis and quality of life [23].…”

Obstructive Jaundice Expands Intrahepatic Regulatory T Cells, Which Impair Liver T Lymphocyte Function but Modulate Liver Cholestasis and Fibrosis

“…Obstructive jaundice leads to intrahepatic inflammation and fibrosis. Jaundiced patients are at increased risk for complications following surgical procedures (2-6), and suffer from significant metabolic (7, 8) and immunologic derangements (9-11), including altered proliferative responses among splenic and peripheral blood lymphocytes (10, 12). The effects of BDL on bulk liver T cells and Treg have not been defined.…”

Morphological changes in the liver and kidneys of rats subjected to terminal ileum exclusion during obstructive cholestasis

“…There was an improvement in biochemical hepatic function tests in most of them following biliary drainage, except in the studies by Younes et al 11 Marinelli Ibarreta et al…”