An experimental study on mechanism of regurgitation of the intrabiliary endotoxin into the blood stream in obstructive jaundice]

Using adult mongrel dogs with or without obstructive jaundice (OJ) the significance of the biliary pressure and the route of regurgitation were investigated by intrabiliary injection of endotoxin (ET) (10 micrograms/kg) or saline (control group) under various intrabiliary pressure levels (not carried, 25cmH2O, 35cmH2O). Some of dogs were cannulated into the thoracic duct for the purpose of drainage of the hepatic lymph. The dogs with OJ, of which the common biliary duct had been ligated and resected for two weeks, had ET shock under lower intrabiliary pressure level (25cmH2O) than the dogs without OJ. The drainage of the hepatic lymph could not attenuate ET shock. The ET volume per minute and the total ET volume extracted from the thoracic duct lymph was not increased in the dogs with OJ compared with the control group, while they were significantly increased in the dogs without OJ in proportion to the intrabiliary pressure level. These results suggest that in OJ, ET shock is easily caused by regurgitation of the intrabiliary ET into the blood stream under lower intrabiliary pressure level, and the intrabiliary ET is mainly regurgitated by cholangio-venous reflux, while the cholangio-lymphatic pathway does not function for the route of regurgitation.