Cytoprotective effect of prostaglandin I2 on ischemia-induced hepatic cell injury.

The protective effect of prostaglandin I2 (PGI2) on ischemia-induced liver cell injury was investigated during 60-min, 75-min, and 90-min liver ischemia. Vehicle-treated rats tolerated the 75-min hepatic ischemia poorly. Only 25% of the rats in this group survived more than 7 days. However, the survival rate of PGI2-treated rats (350 ng/kg/min) significantly improved to 67%. Liver cell organelles were well-preserved by the PGI2 treatment. Adenosine triphosphate levels in the liver of the PGI2-treated rats were significantly higher than those of vehicle-treated rats at 60 min of reoxygenation following 75-min ischemia. Cyclic 3'-5' adenosine monophosphate levels markedly increased during 60-min PGI2 infusion. Cyclic 3'-5' guanosine monophosphate levels also significantly increased during the PGI2 infusion and were still higher than those of vehicle-treated rats at the end of the 75-min ischemia. Although the exact cytoprotective mechanism of PGI2 at the cellular level is still unclear, our results demonstrate that elevated ATP and cyclic nucleotides levels play an important role in liver cell preservation during ischemia.

Hepatocellular carcinoma in a case of Dubin-Johnson syndrome treated successfully with right extended lobectomy.

A 57-year-old man with hepatocellular carcinoma and liver cirrhosis combined with Dubin-Johnson syndrome was successfully treated by extensive right hepatic lobectomy. While the preoperative serum bilirubin level is one of the criteria in determining the indication for radical hepatic resection, it does not play a decisive role in the case of combined Dubin-Johnson syndrome.

[Transhepatic biliary drainage as a method in the diagnosis and treatment of obstructive jaundice]. / Drenaje biliar transparietohepático como método de diagnóstico y tratamiento en las ictericias obstructivas.

Percutaneous transhepatic biliary drainage was performed on eleven jaundiced patients, who had obstruction of the bile duct, in order to determine the exact site and nature of the obstruction and to alleviate the jaundice. In the present series, six patients were treated with external biliary drainage. Four of them received this treatment prior to radical surgery. In the remaining two cases the external drainage was a palliative procedure. In five patients, the drainage catheter was internalized through the obstructed bile duct (internal biliary drainage). One of these patients was subsequently treated with radical surgery. In two cases, the internal biliary drainage was palliative. In the two remaining cases, intraluminal selective irradiation was introduced via Iridium 192 flexible wires. Severe hemobilia occurred in one patient, who was successfully treated by lithotomy and "T" tube drainage. We conclude that the simplicity and low cost of these drainage procedures recommend them as extremely useful for the diagnosis and treatment of obstructive jaundiced patients.

Drenaje biliar transparietohepático como método de diagnóstico y tratamiento en las ictericias obstructivas / [Transhepatic biliary drainage as a method in the diagnosis and treatment of obstructive jaundice]

Percutaneous transhepatic biliary drainage was performed on eleven jaundiced patients, who had obstruction of the bile duct, in order to determine the exact site and nature of the obstruction and to alleviate the jaundice. In the present series, six patients were treated with external biliary drainage. Four of them received this treatment prior to radical surgery. In the remaining two cases the external drainage was a palliative procedure. In five patients, the drainage catheter was internalized through the obstructed bile duct (internal biliary drainage). One of these patients was subsequently treated with radical surgery. In two cases, the internal biliary drainage was palliative. In the two remaining cases, intraluminal selective irradiation was introduced via Iridium 192 flexible wires. Severe hemobilia occurred in one patient, who was successfully treated by lithotomy and [quot ]T[quot ] tube drainage. We conclude that the simplicity and low cost of these drainage procedures recommend them as extremely useful for the diagnosis and treatment of obstructive jaundiced patients.

Drenaje biliar transparietohepático como método de diagnóstico y tratamiento en las ictericias obstructivas. / [Transhepatic biliary drainage as a method in the diagnosis and treatment of obstructive jaundice]

Percutaneous transhepatic biliary drainage was performed on eleven jaundiced patients, who had obstruction of the bile duct, in order to determine the exact site and nature of the obstruction and to alleviate the jaundice. In the present series, six patients were treated with external biliary drainage. Four of them received this treatment prior to radical surgery. In the remaining two cases the external drainage was a palliative procedure. In five patients, the drainage catheter was internalized through the obstructed bile duct (internal biliary drainage). One of these patients was subsequently treated with radical surgery. In two cases, the internal biliary drainage was palliative. In the two remaining cases, intraluminal selective irradiation was introduced via Iridium 192 flexible wires. Severe hemobilia occurred in one patient, who was successfully treated by lithotomy and [quot ]T[quot ] tube drainage. We conclude that the simplicity and low cost of these drainage procedures recommend them as extremely useful for the diagnosis and treatment of obstructive jaundiced patients.