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PubMed1988

Resection of hepatocellular carcinoma with obstructive jaundice caused by compression of the common hepatic duct.

We treated a patient with hepatocellular carcinoma in whom jaundice was caused by obstruction of the common hepatic duct because of compression by the tumor. Percutaneous transhepatic cholangiodrainage was performed preoperatively. The tumor was entirely in the medial segment of the liver, without invasion of the hepatic ducts, and medial segmentectomy was performed. As of the end of 1985, 58 cases of hepatocellular carcinoma complicated by extrahepatic obstructive jaundice have been reported in Japan. In only four was obstructive jaundice caused by extraluminal biliary compression. We review ten patients treated by liver resection.

Aged↗
PubMed1991

[Hepatic functional evaluation using the galactose tolerance test in patients with obstructive jaundice].

Hepatic functional mass was evaluated in patients with obstructive jaundice using the galactose tolerance test (GaTT), which reflected cytosolic function of hepatocyte. The T-1/2 values as an index on the GaTT were significantly prolonged in patients with obstructive jaundice in comparison with control subjects whether before or after percutaneous transhepatic biliary drainage (PTBD). But in each cases, some showed nearly normal GaTT-T/2 value and others showed severely prolonged value. Patients with obstructive jaundice could be divided into two groups according to the GaTT-T/2 value before PTBD. The decreasing rate of serum bilirubin level "b" after PTBD was significantly fair in the group A patients (good GaTT-T/2 value before PTBD) than the group B (poor GaTT-T/2 value before PTBD) (P less than 0.05). It was that GaTT-T/2 before PTBD which represented hepatic cytosolic functional mass could predict the effect of PTBD in patients with obstructive jaundice.

Aged↗
PubMed2004

Safe and permissible limits of hepatectomy in obstructive jaundice patients.

The safe and permissible limits of hepatectomy in obstructive jaundice patients and the usefulness of preoperative portal embolization (PE) for increasing the limit for safe hepatectomy were examined. We classified 416 patients with hepatectomy performed over 9 years under the following headings: normal liver function (n = 242); chronic hepatitis (n = 71); liver cirrhosis (n = 64); and liver after relief of obstructive jaundice (n = 39). Hepatectomy was done after the total bilirubin level was reduced below 3 mg/dl by preoperative biliary drainage. Factors influencing the maximum total bilirubin level measured within 2 weeks after hepatectomy were investigated, and this level was taken to reflect the degree of surgical stress. PE was carried out in 18 patients with obstructive jaundice. The maximum total bilirubin, expressed as a logarithm, was significantly correlated with the percent of liver resected in all groups. Hepatectomy followed by a maximum total bilirubin of less than 8.5 mg/dl was accepted as safe, and hepatectomy followed by a bilirubin level of 14.4 mg/dl was deemed the maximum permissible resection. On the basis of these results, the safe and permissible limits of hepatectomy in patients with obstructive jaundice were 48.7% and 71.6%, respectively. PE decreased the maximum total bilirubin from 8.5 mg/dl to 3.9 mg/dl when 48.7% of the liver (a safe proportion in all cases) was resected; PE increased the safe limit of hepatectomy from 48.7% to 67.4% when a maximum posthepatectomy total bilirubin level of 8.5 mg/dl was accepted as safe.

Bilirubin↗
PubMed1978

[Clinical and experimental study on hepatorenal syndrome in terms of obstructive jaundice (author's transl)].

In our department, hepatorenal syndrome was highly associated with obstructive jaundice and was seen in 9.2 percent of patients with obstructive jaundice. This syndrome developed when in underlying hepatic disease, acute renal failure supervened. Histological findings of renal failure caused by obstructive jaundice were summarized as tubular necrosis and the presence of protein-like substance in the glomerulus, which were mostly reversible and similar to those seen in shock. To investigate the pathogenesis of hepatorenal syndrome, experimentally the common duct in dog was ligated to produce obstructive jaundice and B. Klebsiella was injected into the bile duct to produce cholangiolitis. From this study, it was evident that cholangiolar infection was closely correlated with the manifestation of renal failure. In fact, without acquiring infection, renal failure did not occur. Moreover, this infection produced endotoxemia with high incidence. Therefore, it is assumed that this cholangiolar infection plays an important role in the pathogenesis of hepatorenal syndrome caused by obstructive jaundice.

Acute Kidney Injury↗
PubMed2001

The changes of protein kinase C activity in peripheral blood lymphocytes in the patients with obstructive jaundice and the implication.

The roles of protein kinase C (PKC) signal pathway in the pathogenesis of obstructive jaundice were studied. PKC from cytosolic and membrane fractions of peripheral blood lymphocytes (PBL) in 51 patients with obstructive jaundice and 16 cases of normal controls was isolated and purified. The activities of PKC were determined by radioactive isotope gamma-32P-ATP-catalyzing assay. The results showed that the total PKC activities in PBL in the patients with obstructive jaundice were significantly increased as compared with those in the normal controls (P < 0.01). Moreover, the membrane PKC activities and their percentages of the total PKC activities were higher in obstructive jaundice group than in those in the normal controls (P < 0.05). The total PKC activities in PBL in the patients with obstructive jaundice were significantly positively correlated with the levels of soluble IL-2 receptor (sIL-2R) (r = 0.58, P < 0.01) and the degree of jaundice (T-BIL) (r = 0.67, P < 0.01) in serum. It was concluded that the activities of PKC signal pathway was related with the degree of T-BIL. PKC signal pathway might took part in the activation of T-lymphocytes in the patients with obstructive jaundice and play an important role in the immune regulation and the assessment of pathosis in the patients with obstructive jaundice.

Adult↗