Percent cholesterol absorption was determined by intestinal perfusion technique using triple lumen tube before and after administration of three bile acids (ursodeoxycholic acid, chenodeoxycholic acid, cholic acid) one month each and consecutively in six normal volunteers.
UDCA significantly decreased percent cholesterol absorption in all cases. CDCA did not affect, but CA increased percent cholesterol absorption in five out of six cases. The admi nistered bile acid became predominant after one month in bile, and cholesterol saturation index decreased significantly during UDCA and CDCA but was not altered during CA administration.
UDCA and CDCA did not affect serum lipid levels but CA significantlydec reased HDL -cholesterol.
UDCA and CDCA have different effects on intestinal cholesterol absorption which lead the author to confirmation that they have different mechanism of action of dissolving cholesterol gallstones.

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Operative choledochoscopy following cholangiography has been utilized to reduce the incidence of retained stones. However, comparison of choledochoscopy and intraoperative cholangiography has been described in few reports. During a period of 6 years,99 patients underwent bile duct exploration and choledocholithotomy, in whom 10 had suspected retained stones.
Complete removal of bile duct stones was thought to be achieved in 88 pati e n ts and T -tude drain was inserted. In 56 patients, routine intraoperative cholangiography was performed and after the operation ductal stones were found in 10 (18%). In 33 patients, intraoperative choledochoscopy was performed and ductal stones were found in only one (3%).
The result of this study suggests that intraoperative choledochoscopy redu c es the incidence of missed bile duct stones.

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Cases of duodenal diverticulum complicated by the presense of stones seem extremely rare. A case of duodenal diverticulum containing a stone, with cholelithiasis and cholecyst-diverticular fistula is here in reported.
The patient i s a woman, aged 76 years, complaing of upper abdoninal discomfort. ERC and CT scan revealed the fistula between cholecyst and duodenal diverticulum and a stone in the diverticulum. On October 20,1987, operation was performed. The gallbladder was atrophic and adherent to the duodenum. In mobilizing the duodenum and freeing it from the gallbladder, the fistulas communication between the gallbladder and duodenal diverticulum was divided. The diverticulum itself contained a stone. After cholecystectomy, in order to remove this stone, the diverticulum was opened. The stone in the diverticulum was a gallstone, mixed stone, and chemical analysis of the stone showed it contained cholesterol and calcium bilirubinate.

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A 66-year-old female complaining of anorexia was admitted on September 24,1986. US and DIG revealed many stones in the common bile duct and the gallbladder, and severe dilatatio n of the common bile duct.
The first operation procedure was cholecystectomy, choledocholithotomy and papilloplasty. Two weeks later cholangiography from T-tube was revealed severe stenosis of the distal common bile duct. Then malignancy was highly suspected. Biopsy passing through T-tube was significant to rule out malignancy.
Its result was no malignancy, so we avoided excessive surgical procedure.

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