Bile acid excretion during drainage of extrahepatic cholestasis with refeeding of bile

Abstract

Hepatic and renal excretion of individual bile acid conjugates were studied in four patients with extrahepatic cholestasis during 3 weeks of percutaneous transhepatic drainage with bile refeeding. The study involved isolation and determination by gas chromatography-mass spectrometry of individual bile acids separated into glycine, taurine and sulphate conjugates simultaneously in bile, serum and urine. In bile cholic, chenodeoxycholic and deoxycholic acids were chiefly found as glycine or taurine conjugates and in high concentrations, which indicated a large capacity of the post-cholestatic liver to excrete these conjugates. A minor portion of cholic, chenodeoxycholic and deoxycholic acids and all of lithocholic and 3β- hydroxy-5-cholenic acids in the bile were recovered as sulphate conjugates. The biliary concentration of sulphated bile acids was low, but increased during drainage with refeeding of bile indicating a gradually more efficient hepatic elimination of sulphated bile acids. The urinary concentrations of the individual bile acid conjugates decreased when the biliary concentration increased.

Key-words:

• bile acid analyses
• obstructive jaundice
• percutaneous transhepatic drainage
• serum
• urine