scholarly journals Changes in Biliary Lipid Concentrations in Bile Duct Obstruction: An Experimental Study

1986 ◽  
Vol 79 (9) ◽  
pp. 522-527 ◽  
Author(s):  
Xu Guorong ◽  
C J C Kirk ◽  
A W Goode
Keyword(s):  
Experimental Study ◽  
Bile Duct ◽  
Bile Acids ◽  
Significant Role ◽  
Biliary Obstruction ◽  
Enterohepatic Circulation ◽  
Biliary Lipid ◽  
Complete Obstruction ◽  
Duct Obstruction ◽  
Biliary Lipids

Changes in biliary concentrations of bile acids, phospholipids and cholesterol and biliary pressures were measured in dogs. These parameters were studied during 7-day periods of partial biliary obstruction, of varying degrees, and after 24-hour and 48-hour periods of complete obstruction. The samples were obtained via an exteriorized but intact enterohepatic circulation allowing the introduction of varying degrees of obstruction and bile sampling. Biliary obstruction reduced the concentration of all biliary lipids especially when the obstruction produced pressures in excess of 75% of the maximum biliary secretion pressure. Only immediately after the release of a 48-hour period of complete obstruction did the risk of cholesterol supersaturation of bile occur. However, at that time there was a greatly reduced concentration of lipids in the bile and the amount of cholesterol that could potentially have precipitated was very small. It is suggested that this supersaturation would not play a significant role in the formation of gallstones.

scholarly journals Bile acid diarrhoea: from diagnosis to treatment

2020 ◽  
Vol 18 (5) ◽  
pp. 36-41
Author(s):  
V.P. Novikova ◽  
◽  
L.N. Belousova ◽  
Keyword(s):  
Bile Acid ◽  
Bile Duct ◽  
Bile Acids ◽  
Enterohepatic Circulation ◽  
Diet Therapy ◽  
Diagnostic Methods ◽  
Chronic Diarrhoea ◽  
Common Cause ◽  
Diagnosis And Management

Bile acid diarrhoea is a common cause of chronic diarrhoea associated with disturbance of the enterohepatic circulation: either excessive biosynthesis/secretion of bile acids or disordered absorption of bile acids in the ileum. At the same time bile acid diarrhoea is an insufficiently studied, frequently underestimated condition, and the questions remain concerning its diagnosis and management. The work discusses the main groups of causes of this pathology, modern diagnostic methods and the difficulties of a differential search. Also, the article offers information about the diet therapy of bile duct diarrhoea and the main groups of administered medications, in particular, modern enterosorbents.

Hepatic and ileal transport and effect on biliary secretion of norursocholic acid and its conjugates in rats

1991 ◽  
Vol 261 (6) ◽  
pp. G1057-G1064
Author(s):  
J. Lillienau ◽  
L. R. Hagey ◽  
B. Borgstrom
Keyword(s):  
Bile Acids ◽  
Bile Flow ◽  
Enterohepatic Circulation ◽  
Biliary Lipid ◽  
Perfusion Technique ◽  
Hepatic Transport ◽  
Rate Of Absorption ◽  
Cholesterol Secretion ◽  
Hepatic Biotransformation

The enterohepatic circulation of norursocholic acid (nUC) and its glycine (nUCG) and taurine (nUCT) conjugates was investigated in the rat; cholic acid (C) was studied as control. The biliary recovery of intravenously infused 14C-labeled bile acids was high: nUC, 88%; nUCG, 80%; nUCT, 99%, and C, 90%. Biliary recovery after the same bile acids were infused intraduodenally was similar: nUC, 90%; nUCG, 66%; nUCT, 97%; and C, 99%. The two conjugated bile acids, nUCG and nUCT, were not biotransformed during intestinal or hepatic transport; nUC was also secreted largely unchanged, but approximately 10% was secreted as an unknown conjugate or sulfate; C was completely conjugated with taurine or glycine. To compare the rates of active ileal transport, biliary recovery was measured after an in situ ileal perfusion technique. The rate of absorption of nUC, nUCG, and nUCT was one-fourth to one-half that of cholyltaurine, which served as control. Competition experiments indicated that the same transport system was involved. When infused intravenously, nUC, nUCG, and nUCT induced far less biliary lipid secretion than an identical dose of C; the secretion of both phospholipid and cholesterol was decreased, cholesterol to a greater extent than phospholipid. It is concluded that nUC and its conjugates are well transported by the ileum, are efficiently secreted into bile without undergoing appreciable hepatic biotransformation, and induce bile flow as other hydrophilic bile acids, but in contrast to C induce little phospholipid and cholesterol secretion into bile.

scholarly journals Diagnostic Value of Dynamic Contrast-Enhanced Magnetic Resonance Imaging in the Evaluation of the Biliary Obstruction

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Mehmet Bilgin ◽  
Hüseyin Toprak ◽  
Mehmet Burgazli ◽  
S. Sennur Bilgin ◽  
Ritvan Chasan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bile Duct ◽  
Magnetic Resonance ◽  
Biliary Obstruction ◽  
Contrast Material ◽  
Bile Duct Obstruction ◽  
Resonance Imaging ◽  
Duct Obstruction ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced

Purpose. In this study, our purpose was to investigate the diagnostic efficacy of the dynamic contrast-enhanced magnetic resonance imaging (MRI) method in the patients with bile duct obstruction.Materials and Methods. 108 consecutive patients (53 men, 55 women, mean age;55.77±14.62, range 18–86 years) were included in this study. All the patients underwent conventional upper abdomen MRI using intravenous contrast material (Gd-DTPA) and MRCP in 1.5 Tesla MRI scanner. MRCP images were evaluated together with the T1 and T2w images, and both biliary ducts and surrounding tissues were examined for possible pathologies that may cause obstruction.Results. MRI/MRCP findings compared with final diagnoses, MRI/MRCP in the demonstration of bile duct obstruction sensitivity 96%, the specificity 100%, and accuracy 96.3%, in the detection of presence and level of obstruction, the sensitivity 96.7%, specificity 100%, and accuracy 97.2%, in the diagnosis of choledocholithiasis, the sensitivity 82.3%, specificity 96%, and accuracy 91.7%, and in the determination of the character of the stenosis, sensitivity 95.6%, specificity 91.3%, and accuracy 94.5% were found.Conclusion. The combination of dynamic contrast-enhanced MRI and MRCP techniques in patients with suspected biliary obstruction gives the detailed information about the presence of obstruction, location, and causes and is a highly specific and sensitive method.

scholarly journals Infection by Gram-Negative Organisms via the Biliary Route Results in Greater Mortality than Portal Venous Infection

2003 ◽  
Vol 10 (4) ◽  
pp. 664-669 ◽  
Author(s):  
D. Rohan Jeyarajah ◽  
Mariusz L. Kielar ◽  
Nicole Frantz ◽  
Guy Lindberg ◽  
Christopher Y. Lu
Keyword(s):  
Bile Duct ◽  
Portal Vein ◽  
Biliary Obstruction ◽  
Bile Duct Ligation ◽  
Lethal Dose ◽  
Bile Duct Obstruction ◽  
Sham Operation ◽  
Duct Obstruction ◽  
E Coli ◽  
Duct Ligation

ABSTRACT Cholangitis requires bile duct obstruction and infection. Patients with cholangitis are often more affected than those with infections that reach the liver through the portal vein. We will attempt to study the influences of (i) route of entry and (ii) presence of bile duct obstruction on hepatic infection. C57BL/6 mice received injections of Escherichia coli or lipopolysaccharide into the obstructed bile duct or portal vein and were monitored for survival. Livers were assayed for bacteria, and cytokine mRNA was measured. In order to examine the effect of biliary obstruction on hepatic infection, animals were subjected to bile duct ligation 1 day prior to portal vein injection and were monitored for survival. The 50% lethal dose (LD50) for E. coli injected into the bile duct was 50 CFU/animal; the LD50 for E. coli injected into the portal vein was 5 × 107 CFU/animal. Initial hepatic delivery of bacteria was equivalent 1 h after injection into the bile duct or portal vein. However, by 24 h, a significantly greater amount of bacteria was recovered from the livers of the bile duct-injected group. Interleukin 10 (IL-10) and IL-1RA mRNA was expressed at greater levels in the bile duct-injected group. Prior bile duct ligation followed by portal vein injection resulted in a higher incidence of death than when sham operation was performed prior to portal vein injection. Our data suggest that the increased mortality from cholangitis, compared with that from other hepatic infections, is related to the different route of delivery of pathogen and the maladaptive response (possibly involving IL-10 and IL-1RA) to biliary obstruction itself.

Effect of prolonged bile duct obstruction in the rat on hepatic transport of bilirubin

1985 ◽  
Vol 68 (3) ◽  
pp. 341-347 ◽  
Author(s):  
Jannis Kountouras ◽  
Peter J. Scheuer ◽  
Barbara H. Billing
Keyword(s):  
Bile Duct ◽  
Biliary Obstruction ◽  
Bile Flow ◽  
Hepatic Transport ◽  
Duct Obstruction ◽  
Conscious Animal ◽  
Plasma Bilirubin ◽  
Bile Drainage ◽  
Bile Flow Rate ◽  
The Mean

1. In order to investigate the effect of extra-hepatic biliary obstruction on bilirubin transport, bile flow was re-established after 5, 10, 15 and 28 days when the mean (±sem) plasma bilirubin concentrations of the four groups of five rats were 226 ± 17.9, 201 ± 22.4, 178 ± 8.1 and 145 ± 3.8 μmol/l, respectively. 2. After 12 h of bile drainage in the conscious animal, the mean plasma bilirubin concentrations of the four groups had decreased by 88, 86, 73 and 46%, respectively. 3. The bile flow rate increased with the duration of the obstruction and was maximal in the 28 day obstructed rats, although the bilirubin output in these animals was significantly less than in the other groups. 4. Histological evidence of biliary obstruction was apparent in the livers of the 5 and 10 day obstructed animals. After 15 days of obstruction cirrhosis developed. 5. In conclusion, the disposal of endogenous bilirubin in the bile duct obstructed rat appears to be influenced by the development of cirrhosis.

Influence of bile acid structure on bile flow and biliary lipid secretion in the hamster

1984 ◽  
Vol 247 (6) ◽  
pp. G736-G748 ◽  
Author(s):  
D. Gurantz ◽  
A. F. Hofmann
Keyword(s):  
Bile Acid ◽  
Bile Acids ◽  
Bile Flow ◽  
Enterohepatic Circulation ◽  
Acid Output ◽  
Chain Structure ◽  
Side Chain ◽  
Biliary Lipid ◽  
Lipid Secretion ◽  
Acid Structure

A comprehensive study of the influence of bile acid structure on bile flow and biliary lipid secretion was carried out by infusing pure bile acids at a physiological rate into the proximal small intestine of a bile fistula hamster. Twelve individual bile acids, cholate (C), ursocholate (UC), chenodeoxycholate (CDC), and ursodeoxycholate (UDC) as their glycine (G), taurine (T), or unconjugated form, were studied so that influence of the hydroxy substituents as well as side-chain structure could be defined. The pattern of bile acid output was dependent on bile acid structure and reflected the site and rate of intestinal absorption. Conjugated bile acid output was delayed because of late ileal absorption, and TUC was poorly absorbed. Unconjugated trihydroxy bile acids, C and UC, also exhibited a delay in absorption, while CDC and UDC were absorbed immediately and achieved the highest bile acid output. Unconjugated bile acids were conjugated initially mostly with taurine and then mostly with glycine. The effect of glycine conjugates of each bile acid on bile flow and biliary lipid secretion was similar to that of their corresponding taurine conjugates. All conjugated bile acids induced a similar rate of bile flow (9–15 microliter bile/mumol bile acid), but unconjugated bile acids other than C induced more flow (20–25 microliter bile/mumol bile acid) than their corresponding conjugates. Conjugates of the dihydroxy bile acids induced a greater secretion of phospholipid and cholesterol than cholyl conjugates, whereas conjugates of UC were unique in inducing extremely low phospholipid and cholesterol secretion. For an increase of 1 mumol X min-1 X kg-1 in bile acid output, the increase in phospholipid secretion was 0.072 mumol X min X kg for GCDC and TCDC; 0.051 mumol X min-1 X kg-1 for GUDC and TUDC; and 0.030 mumol X min-1 X kg-1 for GC and TC. Increase in cholesterol output per mumol X min-1 X kg-1 of bile acid output was 0.013 mumol X min-1 X kg-1 for GCDC and TCDC, 0.011 mumol X min-1 X kg-1 for GUDC and TUDC, and 0.005 mumol X min-1 X kg-1 for GC and TC. In general, unconjugated bile acids induced more phospholipid and cholesterol than their corresponding conjugates; however, the rank-order effect of the steroid nucleus substituents was similar to that observed for the respective conjugates. These results indicate that both nuclear and side-chain structure influence the enterohepatic circulation and biliary secretory properties of bile acids.(ABSTRACT TRUNCATED AT 400 WORDS)

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