Alterations of bile secretion indicators with blunt multiple abdominal injury and underlying ischemia-reperfusion of the limbs
Authors: Kuzminskyi I. V. , Grodetskyi V. K. , Thymbalyuk H. Yu. 
Published: January 2022

It is known that ischemia-reperfusion has a significant negative impact on combined trauma. It is clear that there is an impression and dysfunction of internal organs against the background of activation of systemic pathological processes, especially those responsible for detoxification processes. However, these processes are little studied in detail, in particular regarding the violation of bile secretion. There is no clear data, and evidence of exactly how ischemia-reperfusion affects liver function in the case of blunt combined trauma to the abdominal organs and how much bile production deteriorates. This is what has become the subject of research.Objective of research: to study dynamic peculiarities of the liver bile secreting function in response to abdominal injury complicated by hypovolemic shock and ischemic-reperfusion syndrome.   Materials and methods. 80 mature albino male Wistar rats with the body weight of 190-220 grams kept on standard vivarium forage were used in the experiment.      The animals were divided into the control and 3 research groups (containing 8 animals each). Arresting bleeding tourniquet was applied proximally on the lower limbs of rats from the first research group for 120 minutes under thiopental-sodium anesthesia (40 mg/kg-1), which caused development of ischemic-reperfusion syndrome. Closed abdominal injury was simulated by means of delivering two dosed blows in the region of the abdominal cavity in the second research group; hypovolemic shock was simulated by means of cutting the femoral vessels and bloodletting from 20 to 22 % of the circulating blood volume in the group. Injuries from the first two groups were combined in the third group. The control group of animals received anesthesia without formation of any injuries.  Bile secreting function of the liver was studied on the basis of identification of the content of total, conjugated/direct and unconjugated/indirect bilirubin in bile, and the volume of bilirubin conjugation degree in bile.  The animals of the research groups were removed from the experiment under thiopental-sodium anesthesia by means of the total bloodletting from the heart.Results. A considerable disorder of the bile secreting function of the liver was found in response to simulated injuries: bile secretion rate in the first research group in comparison with the control one achieves minimal values in 3 days and remains on the same level till the seventh day of the post-traumatic period. In the second group the parameter does not change during 1-3 days, though it decreases sharply in seven days. Unidirectional decrease was found in the third group till the seventh day of the experiment.The data obtained are clearly indicative of a negative effect of ischemic-reperfusion syndrome on the bile-forming and bile secreting functions of the liver. Effect of the liver function was found both with isolated action and with multiple injuries of the abdominal organs, when bilateral compromised syndrome is observed.    Conclusions: The study proved that the combined blunt trauma of the abdominal organs negatively affects the process of bile formation. Also, in the presence of ischemia-reperfusion of the limb, pathological processes are characterized by a tendency to increase significantly.