Experimental study on impairment of reticuloendothelial system of the contralateral lobe of the liver in localized cholangitis.

我们根据肝脏局部胆管炎影响全肝功能的经验，研究了犬肝脏局部胆管炎对对侧肝叶的影响。8只成年狗参与了这项研究。其中，局部胆管炎组5例（A组），对照组3例（B组）。对B3段胆管插管，准备通往该段的肝动脉和门静脉，预备血管袢暂时性闭塞。脂乳试验（LET）评价网状内皮系统（RES）功能。为了评估除胆管炎区外RES的功能，在LET之前闭塞血管。术后立即行第一次LET，术后1周和2周分别行第二次和第三次LET。第二次LET后，a组将0.1 ml生理盐水中加入3 mg内毒素，经导管注入B3。b组单独注射等量生理盐水，第三次LET后处死狗，显微镜下观察肝脏。A组第三期肝组织血清脂质消失率较第二次肝组织明显降低，明确了局限性胆管炎引起对侧肝组织RES损伤。然而，除了碱性磷酸酶和谷氨酰转肽酶外，肝功能检查没有受到胆管炎等负担的影响。胆管炎肝叶可见炎性细胞浸润，胆管狭窄改变及纤维化改变，但对侧肝叶未见特异性改变。在B组，血清脂质消失率在第二次和第三次LET之间没有差异。综上所述，犬局限性胆管炎损害了对侧叶RES的功能。

Based on our experiences that localized cholangitis in the liver affected the function of whole liver, we studied the influences of localized cholangitis to the contralateral lobe of the liver in dog.Eight adult dogs were involved in this study. Of these, five were entered in the group of localized cholangitis (Group A), and three were entered in control group (Group B). The bile duct of B3 was cannulated and the hepatic artery and portal vein to that segment was prepared for tentative occlusion with vessel loops. Lipid Emulsion Test (LET) was employed to estimate the function of reticulo-endothelial system (RES). For estimating the function of RES other than the area baring cholangitis, blood vessels were occluded prior to LET.Just after the operation, the first LET was performed, and the second and the third LET were performed one and two weeks after the operation, respectively. After the second LET,3 mg of endotoxin in 0.1 ml of saline was injected into the B3 through a catheter in Group A.Same amount of saline alone was injected into the B3 in Group B.After the third LET,dogs were sacrificed and the liver was investigated microscopically.In Group A,disappearance rate of lipid in the serum at the third LET was significantly decreased compared to the second LET,thus the impairment of RES in contralateral lobe of the liver caused by localized cholangitis was clarified. However, liver function tests other than alkaline phosphatase and gamma glutamyl transpeptidase was not affected by such burden as cholangitis. Although infiltration of inflammatory cells in the portal triad, stenotic change of bile ducts and fibrotic change was seen in the lobe of cholangitis, contralateral lobe was found to have no specific change. In Group B,disappearance rate of lipid in the serum was no difference between the second and the third LET.In conclusion, localized cholangitis in dog impaired the function of RES in the contralatelal lobe.