Some factors affecting the passage of insulin into bile in the rabbit, with some observations on glucagon

1970 ◽  
Vol 175 (1039) ◽  
pp. 167-181 ◽  
Keyword(s):  
Bile Flow ◽  
Hepatic Duct ◽  
Sodium Taurocholate ◽  
Vena Cava ◽  
Biliary Tree ◽  
Hepatic Bile ◽  
Factors Affecting ◽  
Endogenous Insulin ◽  
Hepatic Portal ◽  
Time Required

In anaesthetized rabbits the concentration of insulin in hepatic duct bile is about the same as in hepatic portal blood plasma, and about 50% higher than in plasma from the inferior vena cava. About 20 min elapses between a peak in the concentration of insulin in blood (whether produced by intravenous injection of insulin or by stimulating endogenous insulin production with secretin or glucagon) and the corresponding peak in concentration in hepatic bile. Allowing for the conjectured dead space of the biliary tree, it seems that the time required for insulin to pass through liver cells must be about 17 min. 125 I-labelled glucagon passes from blood to hepatic bile much faster. If bile flow is increased by giving sodium taurocholate, the insulin passing out in hepatic bile per unit time is also increased. Insulin does not affect bile flow, but there is a positive correlation between resting bile flow and the concentration of insulin in bile. Subsidiary observations are that glucagon reduces bile flow, and that the concentration of insulin in gall bladder bile is surprisingly high.

scholarly journals Proximal Extrahepatic Bile Ducts: Comprehensive Review

2021 ◽  
Vol 4 (1) ◽  
pp. 74-93
Author(s):  
M. A. Shorikov ◽  
O. N. Sergeeva ◽  
M. G. Lapteva ◽  
N. A. Peregudov ◽  
B. I. Dolgushin
Keyword(s):  
Bile Duct ◽  
Bile Flow ◽  
Bile Ducts ◽  
Extrahepatic Bile Duct ◽  
Hepatic Duct ◽  
Biliary Tree ◽  
Comprehensive Review ◽  
Extrahepatic Bile Ducts ◽  
And Function ◽  
Variant Anatomy

Proximal extrahepatic bile ducts are the biliary tree segment within formal boundaries from cystic ductcommon hepatic duct junction to sectoral hepatic ducts. Despite being a focus of attention of diagnostic and interventional radiologists, endoscopists, hepatobiliary surgeons and transplantologists they weren’t comprehensively described in available papers. The majority of the authors regard bile duct confluence as a group of merging primitively arranged tubes providing bile flow. The information on the proximal extrahepatic bile duct embryonal development, variant anatomy, innervation, arterial, venous and lymphatic supply is too general and not detailed. The present review brought together and systemized exiting to the date data on anatomy and function of this biliary tract portion. Unique, different from the majority of hollow organs organization of the proximal extrahepatic bile duct adapts them to the flow of the bile, i.e. viscous aggressive due to pH about 8.0 and detergents fluid, under higher wall pressure than in other parts of biliary tree. 

[14C]erythritol clearance and canalicular bile acid-independent flow in the baboon

1982 ◽  
Vol 242 (5) ◽  
pp. G475-G480
Author(s):  
S. M. Strasberg ◽  
R. G. Ilson ◽  
C. N. Petrunka
Keyword(s):  
Bile Acid ◽  
Bile Acids ◽  
Bile Flow ◽  
Quantitative Assessment ◽  
Sodium Taurocholate ◽  
Hepatic Bile ◽  
Bile Formation ◽  
Canalicular Bile

The use of [14C]erythritol for the quantitative assessment of hepatic bile formation has been studied in baboons using sodium taurocholate to generate canalicular bile flow. It has been found that increments in [14C]erythritol clearance are equal to taurocholate-induced increments in bile flow, but there was no change in [14C]erythritol clearance when bile flow was increased by secretin. No evidence was found to support the view that bile acids affect bile acid-independent bile flow.

History of hepatic bile formation: old problems, new approaches

2014 ◽  
Vol 38 (4) ◽  
pp. 279-285 ◽  
Author(s):  
Norman B. Javitt
Keyword(s):  
Bile Acid ◽  
Bile Acids ◽  
Water Flow ◽  
Bile Flow ◽  
Water Movement ◽  
Sodium Taurocholate ◽  
Biliary System ◽  
Hepatic Bile ◽  
Bile Formation ◽  
Osmotic Effect

Studies of hepatic bile formation reported in 1958 established that it was an osmotically generated water flow. Intravenous infusion of sodium taurocholate established a high correlation between hepatic bile flow and bile acid excretion. Secretin, a hormone that stimulates bicarbonate secretion, was also found to increase hepatic bile flow. The sources of the water entering the biliary system with these two stimuli were differentiated by the use of mannitol. An increase in its excretion parallels the increase in bile flow in response to bile acids but not secretin, which led to a quantitative distinction between canalicular and ductular water flow. The finding of aquaglyceroporin-9 in the basolateral surface of the hepatocyte accounted for the rapid entry of mannitol into hepatocytes and its exclusion from water movement in the ductules where aquaporin-1 is present. Electron microscopy demonstrated that bile acids generate the formation of vesicles that contain lecithin and cholesterol after their receptor-mediated canalicular transport. Biophysical studies established that the osmotic effect of bile acids varies with their concentration and also with the proportion of mono-, di-, and trihydroxy bile acids and provides a basis for understanding their physiological effects. Because of the varying osmotic effect of bile acids, it is difficult to quantify bile acid independent flow generated by other solutes, such as glutathione, which enters the biliary system. Monohydroxy bile acids, by markedly increasing aggregation number, severely reduce water flow. Developing biomarkers for the noninvasive assessment of normal hepatic bile flow remains an elusive goal that merits further study.

Biliary excretion of inorganic electrolytes: its role in hepatic bile formation

1985 ◽  
Vol 63 (10) ◽  
pp. 1245-1251 ◽  
Author(s):  
Nicola Tavoloni
Keyword(s):  
Bile Acid ◽  
Guinea Pig ◽  
Bile Acids ◽  
Bile Flow ◽  
Major Change ◽  
Biliary Tree ◽  
Bile Secretion ◽  
Bicarbonate Concentration ◽  
Hepatic Bile ◽  
Bile Formation

To define the role of inorganic electrolyte secretion in hepatic bile formation, the effects of secretin, glucagon, and differently structured bile acids on bile flow and composition were studied in the dog, guinea pig, and rat. In the dog and guinea pig, secretin (2.5–10 clinical units∙kg−1∙30 min−1) increased bile flow and bicarbonate concentration in bile, a finding consistent with the hypothesis that the hormone stimulates a bicarbonate-dependent secretion possibly at the level of the bile ductule–duct. In the rat, secretin (5–15 CU∙kg−1∙30 min−1) failed to increase bile secretion. Glucagon (1.25–300 μg∙kg−1∙30 min−1) increased bile flow in all the three species, and produced no changes in biliary bicarbonate concentrations in the dog and rat. In the guinea pig, however, glucagon choleresis was associated with an increase in bicarbonate concentration in bile, similar to that observed with secretin. The choleretic activities of various bile acids (taurocholate, chenodeoxycholate, glycochenodeoxycholate, tauroursodeoxycholate, and ursodeoxycholic acid, infused at 30–360 μmol∙kg−1∙30 min−1) were similar in the rat (6.9–7.2 μL/μmol), but different in the guinea pig (11–31 μL/μmol). In the latter species, the more hydrophobic the bile acid, the greater was its choleretic activity. In all instances, bile acid choleresis was associated with a decline in the biliary concentrations of chloride, but with no major change in bicarbonate levels. The prominent finding of these studies is that, regardless of whether bile flow was stimulated by hormones or different bile acids, bicarbonate concentrations in bile were always similar to or higher than those in plasma. This is construed to support the view that bicarbonate is transported into bile, possibly at multiple sites within the biliary tree. Its excretion most likely provides the driving force for hormone-induced choleresis, and may in part account for the flow of bile associated with bile acid secretion.

scholarly journals Extraluminal recanalization for postoperative biliary obstruction using transseptal needle

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiroki Horinouchi ◽  
Eisuke Ueshima ◽  
Keitaro Sofue ◽  
Shohei Komatsu ◽  
Takuya Okada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Biliary Obstruction ◽  
Hepatic Duct ◽  
Drainage Tube ◽  
Biliary Strictures ◽  
Hepatic Bile ◽  
Hepatic Bile Duct ◽  
Benign Biliary Strictures ◽  
The Right

Abstract Background Postoperative biliary strictures are commonly related to accidental bile duct injuries or occur at the site of biliary anastomosis. The first-line treatment for benign biliary strictures is endoscopic therapy, which is less invasive and repeatable. However, recanalization for biliary complete obstruction is technically challenging to treat. The present report describes a successful case of treatment by extraluminal recanalization for postoperative biliary obstruction using a transseptal needle. Case presentation A 66-year-old woman had undergone caudal lobectomy for the treatment of hepatocellular carcinoma. The posterior segmental branch of the bile duct was injured and repaired intraoperatively. Three months after the surgery, the patient had developed biliary leakage from the right hepatic bile duct, resulting in complete biliary obstruction. Since intraluminal recanalization with conventional endoscopic and percutaneous approaches with a guidewire failed, extraluminal recanalization using a transseptal needle with an internal lumen via percutaneous approach was performed under fluoroscopic guidance. The left lateral inferior segmental duct was punctured, and an 8-F transseptal sheath was introduced into the ostium of right hepatic duct. A transseptal needle was advanced, and the right hepatic duct was punctured by targeting an inflated balloon that was placed at the end of the obstructed right hepatic bile duct. After confirming successful puncture using contrast agent injected through the internal lumen of the needle, a 0.014-in. guidewire was advanced into the right hepatic duct. Finally, an 8.5-F internal–external biliary drainage tube was successfully placed without complications. One month after the procedure, the drainage tube was replaced with a 10.2-F drainage tube to dilate the created tract. Subsequent endoscopic internalization was performed 5 months after the procedure. At the 1-year follow-up examination, there was no sign of biliary obstruction and recurrence of hepatocellular carcinoma. Conclusions Recanalization using a transseptal needle can be an alternative technique for rigid biliary obstruction when conventional techniques fail.

Factors Affecting the Recognition of the Dilated Biliary Tree in the Jaundiced Patient

1978 ◽  
pp. 125-133 ◽  
Author(s):  
K. J. W. Taylor ◽  
A. T. Rosenfield ◽  
C. S. deGraaff ◽  
B. D. Simonds ◽  
M. Eckstein ◽  
...  
Keyword(s):  
Biliary Tree ◽  
Factors Affecting

scholarly journals Various factors affecting the bacterial corneal ulcer healing: a 4-years study in referral tertiary eye hospital in Indonesia

2015 ◽  
Vol 24 (3) ◽  
pp. 150-5 ◽  
Author(s):  
Muhammad Asroruddin ◽  
Rina L.D. Nora ◽  
Lukman Edwar ◽  
Soedarman Sjamsoe ◽  
Made Susiyanti
Keyword(s):  
Corneal Ulcer ◽  
Ocular Trauma ◽  
Antibiotic Sensitivity ◽  
Pseudomonas Sp ◽  
Chi Square ◽  
Factors Affecting ◽  
Corneal Ulcers ◽  
Time Required ◽  
Mean Time ◽  
Epithelial Healing

Background: Corneal ulcer is one of the most common causes of visual acuity impairment and blindness all over the world. The aim of the study was to evaluate various factors affecting the bacterial corneal ulcers healing, including the predisposing factors, causative organisms, antibiotic sensitivity, as well as the treatment outcomes.Methods: All data were taken retrospectively from medical records of patients who underwent corneal scraping for Gram examination and/or culture over a-4-year period (2008-2011) at the Cipto Mangunkusumo Hospital Jakarta. Treatment outcome were analyzed using Chi-square test, one-way ANOVA, and post-hoc analysis. Mean time required for complete epithelial healing was also investigated.Results: 220 cases of bacterial corneal ulcers in 216 patients were included. The most common risk factors were ocular trauma (45.8%). Gram-positive coccus were found in 65.7% cases other than other microbes. Pseudomonas sp. (25,0%) and Staphylococcus epidermidis (18.4%) were the most common isolates, sensitive to almost all kinds of antibiotics. About 83.0% (106 cases) were improved with antibiotics only, the rest were not improved and worsened. Mean time for complete epithelial healing was 17.5 ± 8.9 days with mild ulcer had the most rapid recovery. Eyes treated with fluoroquinolone eyedrops were healed in 14 days, faster than other regiments.Conclusion: Ocular trauma was the most common risk factor for corneal ulcer, and the most commonly isolated organism was Pseudomonas sp. Most cases were improved with antibiotics, and fluoroquinolone showed faster healing. Complete epithelial healing occurred in about 17.5 days.

scholarly journals Laparoscopic Approach to Left Hepatectomy Using a Standardized Technique

2021 ◽  
pp. 1-3
Author(s):  
Chang Stephen Kin Yong ◽  
◽  
R Ang ◽  
Keyword(s):  
Surgical Technique ◽  
Traditional Approach ◽  
Hepatic Duct ◽  
Laparoscopic Hepatectomy ◽  
Vena Cava ◽  
Laparoscopic Approach ◽  
Liver Parenchyma ◽  
Left Hepatic Duct ◽  
Patient Selection Criteria ◽  
Key Steps

Introduction: The laparoscopic approach in liver surgery has been preferred over the traditional approach in the resection of segments 2 and 3, as laparoscopic surgical technique can be standardized for easy adoption and is minimally invasive. This paper describes the laparoscopic surgical technique and recommends the patient selection criteria in the resection of segments 2, 3 and 4. Methods: This technique involves 2 key steps – early division of the left pedicle before the division of the liver parenchyma and the placement of an instrument beneath the transection plane to simulate a ‘hanging manoeuvre’ with reduced blood loss and allows the expeditious division of the liver parenchyma. Apart from the usual contraindications to liver resections, specific contraindications to this technique include patients with aberrant biliary drainage of right liver segments into the left hepatic duct, patients with tumours abutting the hilar plate and patients with tumours located near the junction of the left hepatic vein and the vena cava. Conclusion: The authors recommend these steps to serve as a standardized technique for laparoscopic hepatectomy of segments 2,3 and 4 in selected patients, allowing the learning curve for this technique to be markedly shortened

scholarly journals Intrahepatic Cholangiocarcinoma Presenting as the Budd-Chiari Syndrome: A Case Report and Literature Review

2005 ◽  
Vol 19 (12) ◽  
pp. 723-728 ◽  
Author(s):  
Joanna K Law ◽  
Jenny Davis ◽  
Anne Buckley ◽  
Baljinder Salh
Keyword(s):  
Inferior Vena Cava ◽  
Intrahepatic Cholangiocarcinoma ◽  
Inferior Vena ◽  
Primary Tumour ◽  
Vena Cava ◽  
Biliary Tree ◽  
Budd Chiari Syndrome ◽  
Radiological Findings ◽  
Chiari Syndrome ◽  
The Right

Intrahepatic cholangiocarcinoma, an increasingly recognized primary tumour of the liver, is associated with a very poor prognosis. A patient with this tumour who presented with Budd-Chiari syndrome (the first to the authors' knowledge in Western literature and only the third patient overall) secondary to extensive thrombosis in his inferior vena cava extending from the right atrium down to his iliac vessels is described. Neither curative nor palliative intervention was deemed to be an option in this patient, who deteriorated rapidly while on anti-coagulants. Postmortem examination confirmed the radiological findings, and histological analysis revealed characteristic appearances of this tumour within the biliary tree and invasion into the inferior vena cava. Furthermore, biliary dysplasia, which can be a precursor to this cancer, was also noted within some of the bile ducts.

Fasting and postprandial hepatic bile flow in unanesthetized opossums

1990 ◽  
Vol 259 (5) ◽  
pp. G745-G752 ◽  
Author(s):  
I. Takahashi ◽  
M. K. Kern ◽  
W. J. Dodds ◽  
W. J. Hogan ◽  
R. D. Layman ◽  
...  
Keyword(s):  
Bile Acid ◽  
Bile Flow ◽  
Common Duct ◽  
Enterohepatic Circulation ◽  
Phase Iii ◽  
Hepatic Bile ◽  
Bipolar Electrodes ◽  
Motor Complex ◽  
The Common ◽  
The Relationship

In conscious opossums, we evaluated the relationship between hepatic bile flow and the intestinal motor function during fasting as well as after feeding. In six opossums, bipolar electrodes were implanted from the gastric antrum to the terminal ileum. After cholecystectomy, the common duct was ligated, and a catheter was tied into the proximal common duct for collecting hepatic bile. During subsequent studies, hepatic bile flow was measured, and bile was returned to the duodenum through an externalized duodenal catheter. Cyclic increases in bile flow during fasting did not show a close correlate with the duodenal migratory motor complex (MMC) cycle. Rather, bile flow showed peak values [0.11 +/- 0.02 (SE) ml/min] when phase III MMC activity reached the midileum. Hepatic bile flow correlated closely with the amount of bile acid secreted by the liver. When the bile acid pool was depleted by diverting bile from the intestine, hepatic secretion of bile fell to uniformly low values of approximately 0.04 ml/min that did not show cyclic variation. Hepatic bile flow after feeding increased to a maximal value of 0.12 +/- 0.01 ml/min at 90 min. We conclude that increases in hepatic bile flow during fasting and after meals are determined mainly by variations in intestinal motor activity that alter small bowel transit and thereby affect the enterohepatic circulation of bile acids.

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