Basic Study of Bilirubin Excretion in Bile Related to Biliary Drainage for Obstructive Jaundice

Shun-ichi Shiozawa

Department of Surgery, Tokyo Women's Medical College Daini Hospital

Serial changes in bilirubin excretion kinetics in bile were examined during the process of biliary drainage for obstructive jaundice, and the relationship of its kinetics to jaundice-protracting factors, the duration of jaundice (2-week group, 6-week group) and biliary tract infection (infection group) was also investigated. Findings were compared in 3 groups in an experimental external biliary drainage model using adult mongrel dogs. In all 3 groups, daily bile bilirubin excretion (V-Bil) reached a maximum 2 to 3 days after biliary drainage was initiated and gradually decreased thereafter, then remained constant for 10 or more days after biliary drainage. However, daily bile bilirubin excretion in the 6-week group and the infection group were lower than in the 2-week group even during the initial stage of biliary drainage, and bilirubin excretion capacity didn't improve during the ovrall follow-up period (p<0.0001). V-Bil correlated with the rate of decrease of serum bilirubin (p=0.010). Bilirubin excretion capacity after biliary drainage was initiated may be governed by maximal bilirubin excretion capacity when the liver is exposed to maximal bilirubin load during the initial stage of biliary drainage (p=0.002) . These findings suggest that V-Bil is a new index that may allow early prediction of the effects of external biliary drainage.

Key words
measurment of bilirubin in bile, evaluation of liver function in obstructive jaundice, external biliary drainage, bilirubin kinetics, biliary infection

Reprint requests
Shun-ichi Shiozawa Department of Surgery, Tokyo Women's Medical College Daini Hospital
2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116 JAPAN

Accepted
September 9, 1997

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