Abstract
In order to clarify the disturbance of bile acid metabolism and indication for administration of UDCA as choleretic agents to post-operative patients with CBA, UDCA tolerance tests were performed in 12 non-jaundiced (Group 1), 7 jaundiced (Group 2) patients and 5 healthy controls. The serum bile acids were measured continuously before and at the timing of 30, 60, 120, and 180 min after oral administration of UDCA. The results were as follows ; 1) In group 1, the change in the ratio of sum of cholic acid (CA) and chenodeoxycholic acid (CDCA) at 180 min and sum of those before administration of UDCA [namely ; the ratio change of the sum of CA and CDCA] was significantly correlated to the postoperative period (r=0.64, p < 0.05). 2) In group 1, the ratio change of serum total bile acid was significantly correlated to that of the sum of CA and CDCA (r=0.77, p < 0.01). 3) Σ⊿ UDCA (parameter for absorption disturbance of bile acid) showed no significant difference between the two patients-groups. Σ⊿ GUDCA (parameter for excretion disturbance of bile acid) was significantly higher in group 2 than that in group 1 (p < 0.05). In Conclusion ; 1) UDCA administration to Group 1 become overload on liver fynction with the longer post-operative period, therefore it should not be over 80 months (about 6 years) after radical operation. 2) It is proposed that the ratio change of serum total bile acid was useful index to reveal latent bile acid metabolism disturbance. 3) The liver capacity to handle the loaded UDCA in Group 2 patients was well preserved as well as in group 1 patients. The liver capacity to excrete the loaded UDCA in Group 2 patients was inferior to that in group 1 patients.
