DIAGNOSTIC SIGNIFICANCE OF COIL PLANET CENTRIFUGATION IN OBSTRUCTIVE JAUNDICE
Deviation of hemolysis patterns of coil planet centrifugation (CPC) were observed sequentially at a week interval for more than three weeks in 28 cases of obstructive jaundice (cholelithiasis 21, malignant biliary obstruction 5, primary biliary cirrhosis 1 and primary sclerosing cholantitis 1). (1) As already pointed out by various investigators, the deviation of hemolysis end point (HEP) to lower osmolar side is characteristic of biliary obstruction (HEP was 63.5 mOsm in benign biliary obstruction, while it was 41.2 mOsm in malignant biliary obstruction on the average). (2) Shift of hemolysis starting point (HSP) should also be observed with attention, because it often deviates to hyperosmolar side in benign obstruction, especially in its recovery stage. (3) In general, HEP and HSP shift to lower osmolar side in malignant obstruction. At the same time the hemolysis curves mostly assume a T type pattern. However, in aggravation, they are of R type pattern. Therefore, observation of hemolysis curves is valuable for diagnostic purpose. (4) In primary biliary cirrhosis or primary sclerosing cholangitis the CPC patterns remain within the normal range despite the presence of overt signs of biliary obstruction.
