[Experimental study on the development of endotoxemia in biliary tract infection with special reference to lymphatic...

A study was made on the pathway of the endotoxin from the biliary tract into the circulation, using adult mongrel dogs divided into 10 groups primarily with or without thoracic duct drainage. The biliary duct pressure level of 25, 35, and 55 cm saline was maintained by infusing physiological saline into the bile duct. Each level was maintained for a 10-minute period following the intrabiliary infusion of endotoxin 10 mcg/kg. The endotoxin level in arterial and portal blood and in thoracic lymph increased with increment of biliary duct pressure. The endotoxin level in the thoracic lymph was more than 10 times higher than that in blood. At 35 and 55 cm saline of biliary duct pressure, the groups with or without thoracic lymph drainage did not show any significant difference in blood endotoxin level, or moreover, endotoxin shock developed in each group. These findings imply that at high biliary pressure such as 35 or 55 cm saline, endotoxin in the bile duct directly appears in the sinusoid. At low biliary pressure such as 25 cm saline, endotoxin was detected only in thoracic lymph and endotoxemia did not develop.