伊藤 精彦 東京大学, 医学部, 医員
今西 宏明 東京大学, 医学部(病), 医員
上寺 祐之 東京大学, 医学部, 医員
UETERA Yushi UNIVERSITY of TOKYO,Department of Medicine Attending Doctor
ITOH Akihiko UNIVERSITY of TOKYO,Department of Medicine Attending Doctor
Based on our experiences that localized cholangitis in the liver affected the function of whole liver, we studied the influences of localized cholangitis to the contralateral lobe of the liver in dog.
Eight adult dogs were involved in this study. Of these, five were entered in the group of localized cholangitis (Group A), and three were entered in control group (Group B). The bile duct of B3 was cannulated and the hepatic artery and portal vein to that segment was prepared for tentative occlusion with vessel loops. Lipid Emulsion Test (LET) was employed to estimate the function of reticulo-endothelial system (RES). For estimating the function of RES other than the area baring cholangitis, blood vessels were occluded prior to LET.Just after the operation, the first LET was performed, and the second and the third LET were performed one and two weeks after the operation, respectively. After the second LET,3 mg of endotoxin in 0.1 ml of saline was injected into the B3 through a catheter in Group A.Same amount of saline alone was injected into the B3 in Group B.After the third LET,dogs were sacrificed and the liver was investigated microscopically.
In Group A,disappearance rate of lipid in the serum at the third LET was significantly decreased compared to the second LET,thus the impairment of RES in contralateral lobe of the liver caused by localized cholangitis was clarified. However, liver function tests other than alkaline phosphatase and gamma glutamyl transpeptidase was not affected by such burden as cholangitis. Although infiltration of inflammatory cells in the portal triad, stenotic change of bile ducts and fibrotic change was seen in the lobe of cholangitis, contralateral lobe was found to have no specific change. In Group B,disappearance rate of lipid in the serum was no difference between the second and the third LET.
In conclusion, localized cholangitis in dog impaired the function of RES in the contralatelal lobe.