ALTERATIONS OF BILE PIGMENT METABOLISM IN BILIARY TRACT DISEASE

The surgeon is frequently called on to perform operations on the extrahepatic bile passages without adequate knowledge of the extent of the hepatic lesion. Too often emphasis is placed on the disease of the gallbladder or common duct only, without estimating the associated hepatic damage. It has seemed to us that the extent of hepatic damage in all surgical lesions of the biliary apparatus should be determined, previous to operation, in the hope that some light might be thrown on the operative prognosis and the end-result. An accurate estimation of hepatic damage is complicated and complex because of the manifold functions of the liver. We have, therefore, confined ourselves in this study to an investigation of the pigment metabolism of the liver. We realize that this presents only one aspect of the subject, but we believe that if this function shows any alteration, in the absence of gross obstruction, it