SUMMARY Six patients with stones retained in the common bile duct after cholecystectomy and common duct exploration were treated by intraductal infusion of a sodium cholate solution. In the five patients whose stones were between the T-tube and the duodenum the treatment was successful within a few days. A stone became transiently impacted in the ampullary region soon after beginning therapy in three patients and produced mild pancreatitis in two. The only failure was in a patient whose stone was between the T-tube and the liver.
The relative concentrations of individual nonsulfated bile acids were determined in samples of serum and bile obtained simultaneously from 16 patients with biopsy-proven alcoholic cirrhosis. A highly significant (P less than 0.001) correlation was found between the fasting relative concentrations of each of the three major bile acids (cholic, chenodeoxycholic, and deoxycholic) in serum and bile. This relationship persisted after manipulation of bile acid pools produced by feeding of individual bile acids. We conclude that the relative concentrations of individual nonsulfated bile acids in serum accurately reflect those in bile and that measurement of individual serum bile acids may be used for screening and serial determination purposes. In particular, low levels of biliary deoxycholate can be reliably predicted by serum measurements.
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