Morphologic and Biochemical Changes in Dogs After Portacaval Shunt Plus Bile Fistula or Ileal Bypass: Failure of Bile Fistula or Ileal Bypass to Prevent Hepatocyte Atrophy

Authors

  • Jon S. Thompson,

    1. University of Nebraska, Medical Center, Omaha, Nebraska; Department of Pathology, Saint Mary's Hospital and Medical School, London, England; Kumamoto University, School of Medicine, Kumamoto, Japan; Rockefeller University, New York, New York; University of Bari, Gastroenterology Department, Bari, Italy; and Department of Surgery, University of Pittsburgh Health Center, Pittsburgh, Pennsylvania 15261
    Search for more papers by this author
  • Kendrick A. Porter,

    1. University of Nebraska, Medical Center, Omaha, Nebraska; Department of Pathology, Saint Mary's Hospital and Medical School, London, England; Kumamoto University, School of Medicine, Kumamoto, Japan; Rockefeller University, New York, New York; University of Bari, Gastroenterology Department, Bari, Italy; and Department of Surgery, University of Pittsburgh Health Center, Pittsburgh, Pennsylvania 15261
    Search for more papers by this author
  • Nobuo Hayashida,

    1. University of Nebraska, Medical Center, Omaha, Nebraska; Department of Pathology, Saint Mary's Hospital and Medical School, London, England; Kumamoto University, School of Medicine, Kumamoto, Japan; Rockefeller University, New York, New York; University of Bari, Gastroenterology Department, Bari, Italy; and Department of Surgery, University of Pittsburgh Health Center, Pittsburgh, Pennsylvania 15261
    Search for more papers by this author
  • Donald J. Mcnamara,

    1. University of Nebraska, Medical Center, Omaha, Nebraska; Department of Pathology, Saint Mary's Hospital and Medical School, London, England; Kumamoto University, School of Medicine, Kumamoto, Japan; Rockefeller University, New York, New York; University of Bari, Gastroenterology Department, Bari, Italy; and Department of Surgery, University of Pittsburgh Health Center, Pittsburgh, Pennsylvania 15261
    Search for more papers by this author
  • Thomas S. Parker,

    1. University of Nebraska, Medical Center, Omaha, Nebraska; Department of Pathology, Saint Mary's Hospital and Medical School, London, England; Kumamoto University, School of Medicine, Kumamoto, Japan; Rockefeller University, New York, New York; University of Bari, Gastroenterology Department, Bari, Italy; and Department of Surgery, University of Pittsburgh Health Center, Pittsburgh, Pennsylvania 15261
    Search for more papers by this author
  • William J. I. Russell,

    1. University of Nebraska, Medical Center, Omaha, Nebraska; Department of Pathology, Saint Mary's Hospital and Medical School, London, England; Kumamoto University, School of Medicine, Kumamoto, Japan; Rockefeller University, New York, New York; University of Bari, Gastroenterology Department, Bari, Italy; and Department of Surgery, University of Pittsburgh Health Center, Pittsburgh, Pennsylvania 15261
    Search for more papers by this author
  • Antonio Francavilla,

    1. University of Nebraska, Medical Center, Omaha, Nebraska; Department of Pathology, Saint Mary's Hospital and Medical School, London, England; Kumamoto University, School of Medicine, Kumamoto, Japan; Rockefeller University, New York, New York; University of Bari, Gastroenterology Department, Bari, Italy; and Department of Surgery, University of Pittsburgh Health Center, Pittsburgh, Pennsylvania 15261
    Search for more papers by this author
  • Thomas E. Starzl

    Corresponding author
    1. University of Nebraska, Medical Center, Omaha, Nebraska; Department of Pathology, Saint Mary's Hospital and Medical School, London, England; Kumamoto University, School of Medicine, Kumamoto, Japan; Rockefeller University, New York, New York; University of Bari, Gastroenterology Department, Bari, Italy; and Department of Surgery, University of Pittsburgh Health Center, Pittsburgh, Pennsylvania 15261
    • Thomas E. Starzl, M.D., Ph.D., Department of Surgery, University of Pittsburgh, 1084 Scaife Hall, Pittsburgh, Pennsylvania 15261.
    Search for more papers by this author

Abstract

External biliary fistula (BF) or ileal bypass (IB) was performed in dogs at the time of or 2 weeks after portacaval shunt (PCS). The pathologic changes in the dog livers 2 to 4 weeks later were compared to those caused by PCS alone. Histopathologic differences between PCS alone vs. PCS plus BF or IB could not be found. Thus, the experiments did not confirm recent observations by others in rats that BF prevents or reverses the hepatic injury of PCS. As estimated by plasma mevalonic acid determinations, the increase in hepatic cholesterol synthesis that is characteristic after BF or IB was suppressed in animals with PCS. BF and IB reduced but did not eliminate the postprandial elevation in serum bile acid that occurs after PCS. The findings have possible relevance in planning the treatment of patients with familial hypercholesterolemia with the combined use of PCS and IB.

Ancillary