[Experimental and clinical studies on the effects of supplemental administration of bile salts after relief of biliary obstruction].

ABSTRACT

Changes of hepatic bile production and hepatocellular function such as bile acid and bilirubin excretion, BSP transfer rate constant, hepatic clearance of bile acid and ultrastructure of bile secretory apparatus after relief of biliary obstruction were investigated in both experimental rat model and clinical cases. The results were as follows Increase in bile acid excretion after total bile fistula was significantly delayed in the jaundiced rats as compared with that of the control rats. In the jaundiced rats, bile salt-induced choleretic effect was significantly augmented and sodium taurocholate infusion caused a marked decrease in bilirubin excretion. Biliary transport of BSP was significantly decreased after biliary decompression, but showed remarkable restoration by simultaneous injection of sodium taurocholate. Hepatic clearance of 14C-taurocholic acid was disturbed in a group with long-term obstruction. The most remarkable morphological alterations were found in the bile canaliculus in the rat with relieved obstruction. Studies on clinical cases showed correlation between bile acid clearance and bilirubin excretion. In conclusion, effective elimination of plasma bilirubin after biliary decompression might be achieved by supplemental administration of bile salts, provided that bile acid clearance remains intact.