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August 1989

Effects of Biliary Obstruction on Hepatic Clearance of Bacteria

Author Affiliations

From the Departments of Surgery (Drs O'Connor Allen, Wilton, and Barke), Medicine (Drs Gerding and Vennes), and Nuclear Medicine (Drs Forstrom and Shafer), Veterans Administration Medical Center, Minneap-olis.

Arch Surg. 1989;124(8):973-977. doi:10.1001/archsurg.1989.01410080109018

• High surgical mortality in patients with obstructive jaundice and sepsis have been attributed to reticuloendothelial system (RES) depression. The purpose of this study was to clarify the effects of mechanical biliary obstruction on RES clearance of pathogenic bacteria by comparing the phagocytic index (K) with the directly measured hepatic uptake of indium 111–labeled bacteria injected into the portal vein of normal dogs and dogs with partial (PBO) or complete biliary obstruction (CBO). No significant difference was observed between the K in normal dogs (0.19±0.08; n=6) and that in dogs with PBO (0.24±0.06; n=5) or CBO (0.21 ±0.03; n=4). There was no significant difference in uptake of radiolabel by the liver among the three groups of dogs. In our model, biliary obstruction had no effect on hepatic RES function and may not represent a significant determinant of mortality in patients with obstructive jaundice.

(Arch Surg 1989;124:973-977)