The effect of experimental bile-duct obstruction on critical biosynthetic functions of the liver

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Abstract
Using biosynthetic activities which have a maximum energy requirement, the effect of obstruction of the bile-duct has been studied in isolated perfused rat livers, and compared with controls undergoing “sham” ligation and with normal animals. The maximum rate of gluconeogenesis from lactate was inhibited by 67 per cent after bile-duct ligation when compared with the normal value. The maximum rate of urea synthesis which occurred in the presence of ornithine was the same in the jaundiced and in the normal animals. ‘Sham’ operation, without ligation of the bile-duct, inhibited gluconeogenesis by less than 20 per cent but doubled the maximum rate of urea synthesis. It is concluded that complete biliary obstruction seriously impairs gluconeogenesis and prevents the normal increase of urea synthesis which occurs in response to trauma and that these changes develop earlier than might be expected after the onset of obstruction. Some possible mechanisms of these effects are discussed. If similar abnormalities of hepatocyte function are demonstrated in man it is suggested that surgical relief of obstructive jaundice is indicated at an early stage.

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