An Experimental Study on the Liver Pathophysiology after the Pringle Maneuver in Obstructive Jaundice -Liberation of Oxygen Free Radicals and Endotoxemia-

Kiyoaki Ouchi, Masanori Suzuki, Kenji Fukuhara, Junichi Mikuni, Taisei Muto, Seiki Matsuno

The First Department of Surgery, Tohoku University School of Medicine

Hepatic oxidative damage can be detected after ischemia-reperfusion and abnormal endotoxin levels. We have investigated the effects of the Pringle maneuver (temporal occlusion of the hepatic blood inflow) on normal dogs, dogs with obstructive jaundice and dogs with hyperbilirubinemia without obstructive cholestasis which was induced by cholangio-caval shunt. The Pringle maneuver only transiently altered the hepatic energy charge and increased lipid peroxide was not found in all three groups of dogs. After the maneuver endotoxemia was not detected in normal dogs and the delayed onset of slightly increased endotoxin level was found in dogs with cholangio-caval shunt. Hepatic total glutathione and α-tocopherol concentrations in both groups of dogs were within control ranges. However, in dogs with obstructive jaundice, this maneuver produced increased systemic and portal endotoxin levels with a decrease in hepatic total glutathione and α-tocopherol content. In conclusion, the Pringle maneuver in dogs with obstructive jaundice appears to trigger the liberation of free radicals by means of an increased absorption of enteric endotoxins. However, oxidative damage, measured as an increment in the content of lipid peroxides, was not detected.

Key words
obstructive jaundice, Pringle maneuver, energy charge, endotoxemia, oxygen free radicals

Reprint requests
Kiyoaki Ouchi The First Department of Surgery, Tohoku University
1-1 Seiryo-cho, Aoba-ku, Sendai, 980 JAPAN

Accepted
February 13, 1991

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