AN EXPERIMENTAL STUDY OF OBSTRUCTIVE JAUNDICE WITH PARTICULAR REFERENCE TO THE INITIAL BILIRUBINEMIA

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Abstract
Ligation of the common bile duct after gall bladder extirpation is followed by an immediate rise in blood bilirubin and it continues to increase at a uniform rate for several hrs. after operation. Studies of the pressure in the common bile duct in the experiments showed that maximal pressure was obtained almost immediately, and the progressive and uniform increase in blood bilirubin followed the application and maintenance of this pressure. If sub-maximal pressure is maintained in the common bile duct, bile continues to be excreted but there is retention of bile pigment, which produces hyperbilirubinemia. From these and other considerations it appears that the increasing intraductal pressure of obstructive jaundice early incapacitates the hepatic cells so that bile pigment is not absorbed from the blood stream, and the liver and biliary ducts do not become saturated with bilirubin.

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