STUDIES IN THE METABOLISM OF THE BILE

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Abstract
In 3 series of 5 dogs each biliary obstruction was produced by ligation of the cystic and common bile ducts, 1 series being kept as a control for the effect of the obstruction alone, a thoracic duct fistula being established and the lymph drained externally in a 2nd series, and in a 3rd series the thoracic duct being ligated at its point of entrance into the jugular vein. The experiments showed that bilirubin and bile acids rapidly accumulate in the blood after the experimental ligation of the cystic and common bile ducts. The lymph shows an even more rapid accumulation of these 2 biliary products and the external drainage of the lymph through a fistula of the thoracic duct delays the changes in the blood stream, but does not prevent the development of icterus. Ligation of the thoracic duct may delay the entrance of bile into the blood stream slightly but not to so great an extent as does a lymphatic fistula. The results indicate that bile resorption in obstructive jaundice may occur through both vascular and lymphatic channels, although the latter possibly are the more active during the 1st few hrs. of obstruction.

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