Background
The combination of hepatic ischemia and cholestasis, both identified as risk factors
for oxidative stress, potentially enhances postischemic reperfusion (I/R) injury.
Preoperative biliary drainage relieves oxidative stress and therefore seems a worthwhile
intervention in cholestatic patients undergoing major liver resection.
Aim
To assess the effect of biliary decompression on I/R injury in a reversible bile duct
ligation (BDL) model in the rat.
Methods
Male Wistar rats were randomized into 3 groups. The first group underwent 30 minutes
of partial liver ischemia after 7 days BDL; the second group underwent internal drainage
(ID) after 7 days BDL and after 5 days, were subjected to partial liver ischemia.
The last group (control animals) underwent 2 sham laparotomies and subsequent ischemia.
Inflammatory response (interleukin [IL]-6, IL-10, GRO/KC, and interferon-γ), hepatic
damage and oxidative stress were assessed during 24 hours of reperfusion.
Results
Cholestatic rats, as compared with the ID and control groups, showed significantly
increased I/R injury as determined by transaminase release, histologic injury score
and neutrophil infiltration. Plasma IL-6, IL-10, and GRO/KC (a CXC chemokine) were
significantly increased in the BDL group (P < .05 vs control and ID). Moreover, the hepatic antioxidant capacity was strongly
decreased in the BDL group (P < .01 vs control and ID). No significant differences for most parameters were seen
in the ID group as compared to the control group.
Conclusion
The cholestatic rat is more susceptible to postischemic liver injury and these injurious
effects were significantly attenuated by biliary decompression.
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Article info
Publication history
Accepted:
March 30,
2008
Identification
Copyright
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
