To the Editor.—In a recent paper, Sadiq et al reported that hepatic venous obstruction did not increase the rate of bile flow.1 We have reported a significant increase in the rate of bile flow with hepatic venous obstruction.2
The methods employed in these two canine studies were quite different. We placed an inflatable Fogerty catheter in the distal common bile duct. This was transiently occluded during measurement of bile flow. Sadiq et al divided the common bile duct to produce a total external biliary fistula. Bile was refed. Without discussing their relative merits, I believe that these two techniques differ to a degree that prevents accurate comparison of results.
We documented bile output in seven dogs before and after partial occlusion of the thoracic inferior vena cava. Sadiq et al question the propriety of inclusion of three of these seven dogs. In two of these we believed
DONOVAN AJ. Hepatic Venous Obstruction and Bile Flow. Arch Surg. 1973;107(5):815–816. doi:10.1001/archsurg.1973.01350230167031
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