Bile composition during total parenteral nutrition
Cano, N.; Marteau, C.; Di Constanzo, J.; Martin, J.; Richieri, J.P.; Mas, J.C.; Crotte, C.; Gérolami, A.
Gastroenterologie Clinique et Biologique 6(8-9): 673-678
1982
ISSN/ISBN: 0399-8320 PMID: 6813183 Document Number: 192724
The role of bile composition in the pathogenesis of cholestasis and cholelithiasis observed during total parenteral nutrition [TPN] was investigated. Eight patients who were treated by TPN and who developed cholestasis were studied. Bile was collected in 2 cases by peroperative gallbladder aspiration and in 6 cases by surgical biliary drainage. Four of these subjects who were investigated again 10 days after the end of TPN and 3 other patients who were not previously treated by TPN, were considered as controls. The biliary cholesterol saturation was normal and similar in the 2 groups of patients. The indirect bilirubin concentration and the proportion of indirect bilirubin to total bilirubin were higher in the group treated by TPN than in controls (P < 0.01). During TPN, bile acid composition was normal in cases with a normal enterohepatic circulation; in these cases, only traces of lithocholic acid were found. No secondary bile acids were found in cases with interrupted enterohepatic circulation. TPN can induce bilirubinate precipitates; cholestasis which occurred during TPN in this series was not due to an elevated biliary secretion of lithocholic acid.