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Bile acid profile and decrement rate of serum total bilirubin after biliary drainage

  • Liver, Pancreas, and Biliary Tract
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Summary

Non-esterified (non-sulfated and non-glucuronidated) bile acid profile in the serum and bile was assessed using mass fragmentation spectrometry in relation to the decrement rate of the serum total bilirubin after relief of the biliary obstruction by external biliary drainage in fourteen patients. Biliary excretion of the total bile acid was decreased and the serum ratio of cholic to cenodeoxycholic acid was low in the patients with refractory jaundice. An unusual bile acid, 3β,7α-dihydroxy-5β-cholan-24-oic acid, was detected in the sera of all patients early after biliary drainage. Disappearance of this bile acid from the serum was delayed in refractory jaundice. These findings suggested that extremely prolonged jaundice after biliary drainage resulted from profound liver cell damage secondary to biliary obstruction.

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Abbreviations

CA:

cholic acid

CA/CDCA:

the ratio of cholic to chenodeoxycholic acid

CDCA:

chenodeoxycholic acid

D-DCA:

[11,11,12-2H3] deoxy-cholic acid

LCA:

lithocholic acid

TBA:

total bile acid

3β7α :

3β,7α-dihydroxy-5β-cholan-24-oic acid

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This study was supported in part by a Grant-in-Aid for Scientific Research from the Ministry of Education, Science and Culture of Japan.

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Kosuge, T., Beppu, T., Iwasaki, S. et al. Bile acid profile and decrement rate of serum total bilirubin after biliary drainage. Gastroenterol Jpn 25, 732–738 (1990). https://doi.org/10.1007/BF02779188

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  • DOI: https://doi.org/10.1007/BF02779188

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