<p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> <p>The concept of endotoxin-mediated rather than direct liver injury in biliary obsruction was
investigated using the experimental rat model of bile duct ligation (BDL) and small bowel
bacterial overgrowth (SBBO). Small identical doses of intravenous endotoxin (bacterial LPS)
caused a significantly more severe liver injury in rats with BDL, compared with sham-operated
rats, suggesting the possible contribution of LPS in this type of liver damage. BDL was then
combined with surgically created jejunal self-filling blind loops, which resulted in SBBO. Plasma
LPS level increased significantly, and once again a more severe liver injury, determined by liver
histology and serum gamma-glutamyl transpeptidase levels, was observed compared with the
control group of rats with BDL+self-emptying blind loops. The data presented suggest that
small amounts of exogenous LPS and/or the ordinarily innocous amounts of LPS constantly
absorbed from the intestinal tract may be critical in the hepatic damage caused by obstruction
of the biliary tract.</p>
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HPB Surg. 1996; 9(2):61-69