[Intrinsic endotoxemia after massive hepatectomy--effect of intra-intestinal antibiotics]

It is known that intrinsic endotoxemia is caused by two main mechanisms, reticuloendothelial system dysfunction and intestinal circulatory failure. We investigated the escape of endotoxin from the intestine under occlusion of the superior mesenteric artery 3 days after 70% liver resection in rabbits. Twelve rabbits were given intra-intestinal antibiotics (Antibiotics group) and other twelve rabbits were given saline only (Control group). The results were as follows. Indocyanine green clearance and lipid clearance were deteriorated in both groups after hepatectomy but the antibiotics group showed a better clearance rate than the control group. Serum endotoxin level was elevated slightly after hepatectomy and then grossly elevated after superior mesenteric artery occlusion, but the antibiotics group showed a lower endotoxin level than that of the control group. Seventy-two hours survival rate was apparently better in the antibiotics group. From those data we conclude that the administration of intraintestinal antibiotics contributed to the maintenance of reticuloendothelial function of remnant hepatic lobe and suppressed the serum endotoxin level after superior mesenteric artery occlusion.