INHIBITION OF BILE ACID ACCUMULATION DECREASED THE EXCESSIVE HEPATOCYTE APOPTOSIS AND IMPROVED THE LIVER SECRETION FUNCTIONS ON OBSTRUCTIVE JAUNDICE PATIENTS
Abstract: Excessive hepatocyte
apoptosis induced by bile acid accumulation occurred in severe obstructive jaundice,
and impair the liver secretion function. The objective of this study is to
determine whether the inhibition of bile acid accumulation through bile duct
decompression affect the excessive hepatocyte apoptosis and caused improvement
the liver secretion functions on human model. In this study we use a before and
after study on severe obstructive jaundice patients due to extra hepatic bile
duct tumor was decompressed. Bile duct decompression was performed as a model
of the role of inhibition of bile acid accumulation inhibition bile acid
accumulation and excessive hepatocyte apoptosis. Bile acid and marker of liver
secretion functions were serially measured. Liver biopsy pre and post
decompression was performed for Hepatocyte apoptosis pathologic examination by
TUNEL fluorescing, which measured by 2 people in double blinded system. Total
bile acid, and liver secretion functions were measured by automated
chemistry analyzer. The result of this
study shows that twenty one severe obstructive
jaundice patients were included. After decompression the hepatocyte
apoptosis index decreased from an average of 53.1 (SD 105) to 11.7 (SD 13.6) (p
< 0.05). Average of bile acid serum decreased from 96.4 (SD 53.8) to 19.9
(SD 39.5) until 13.0 (SD 12.6) μmol/L (p
< 0.05) Total bilirubin decreased from 20.0 (SD 8.9) to 13.3 (SD 5.0) until
6.2 (SD 4.0) mg/dL (p < 0.05), while the phosphates alkaline (ALP) and
γ-glutamil transpeptidase (γ-GT) activities also decreased significantly. In
conclusion, bile acids accumulation and excessive hepatocyte apoptosis through
bile duct decompression improve the liver secretion functions by inhibition mechanism.
Author: Toar J.M. Lalisang,
Raden Sjamsuhidayat, Nurjati C. Siregar, Akmal Taher
Journal Code: jpkedokterangg110218
