Bile Acid Pattern and Cholesterol Saturation of Bile after Cholecystectomy and Endoscopic Sphincterotomy

Abstract

The effect of endoscopic sphincterotomy on bile acid composition and cholesterol saturation of bile has been studied in cholecystectomized patients. Individual bile acids and biliary lipids were measured in hepatic bile of 13 cholecystectomized females aged 56.8 ± 16.6 years more than 9 months (mean 16.7 ± 8.8 months) after sphincterotomy and of 12 cholecystectomized females aged 59.3 ± 11.5 years who served as controls. The sphincterotomy group exhibited a significantly (p < 0.01) higher percentage of chenodeoxycholic acid in bile – 39.2 ± (SD) 7.7% – than the controls with cholecystectomy only (29.1 ± 7.4%), but showed no differences in the proportion of cholic acid (32.4 ± 6.2 vs. 33.6 ± 7.8%). The percentages of the secondary bile acids, deoxycholic acid (25.0 ± 8.8 vs. 32.3 ± 8.3%), and lithocholic acid (1.7 ± 0.8 vs. 2.6 ± 2.3%) were lower, but these differences were not statistically significant. The biliary lipid composition in the sphincterotomy group was not different from that in the controls, resulting in a similar cholesterol saturation index in both groups (1.87 ± 0.60 vs. 2.02 ± 0.60 according to Carey and Small; 1.45 ± 0.32 vs. 1.55 ± 0.32 according to Hegardt and Dam). These findings do not demonstrate any alterations of the bile composition after sphincterotomy which may be expected to have undesirable effects on the biliary and/or gastrointestinal system.

Altered Fecal Bile Acid Pattern in Patients with Inflammatory Bowel Disease

“…Fractovap 4160 model, equipped with an on-column injector and flame ioni zation detector. Analysis conditions and procedure have been described in detail [15,16].…”

Pharmacological Manipulation of Biliary Water and Lipids: Potential Consequences for Prevention of Acute Biliary Pancreatitis

“…In gallstone patients with a gallbladder in situ, sphincterotomy decreases crystallization mainly by lowering cholesterol and total lipid concentrations [68,69]. Sphincterotomy after previous cholecystectomy has no significant effect on cholesterol or total lipid concentrations [70,71].…”

Effect of Endoscopic Sphincterotomy on Bile Acid Pool Size and Bile Lipid Composition in Man

“…The sam ples were immediately stored at -2 0 °C. Total bile acid concentration in bile was determined enzymati cally using 3a-hydroxysteroid dehydrogenase [4], In dividual bile acids were measured by capillary gas chromatography [5], Total phospholipids were ex tracted into chloroform and assayed according to the method of Bartlett [6], Bile was diluted 1:10 v/v with ethanol, and cholesterol was then extracted with pe troleum ether and measured colorimetrically by the method of Abell el al. [7].…”