Original Articles

The American Journal of Digestive Diseases

, Volume 18, Issue 6, pp 455-459

Bile acid secretion and biliary bile acid composition altered by cholecystectomy

  • Juan R. MalageladaAffiliated withGastroenterology Unit, Mayo ClinicMayo Foundation
  • , Vay Liang W. GoAffiliated withGastroenterology Unit, Mayo ClinicMayo Foundation
  • , William H. J. SummerskillAffiliated withGastroenterology Unit, Mayo ClinicMayo Foundation
  • , Willard S. GambleAffiliated withGastroenterology Unit, Mayo ClinicMayo Foundation

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Abstract

After cholecystectomy, bile secretion is continuous and 24-hour bile acid output exceeds that in health. Cholecystokinin-pancreozymin (CCK-PZ) influences neither bile acid secretion nor the bile acid composition of bile after the operation. It is proposed that the absence of the gallbladder causes more rapid enterohepatic recycling of bile acids and therefore increased bile acid secretion. The bile acid composition of bile following cholecystectomy is abnormal for the same reasons. A high proportion of secondary bile acids is present, including several found to be keto bile acids, and this is attributed to increased exposure of the bile acid pool to degradation by intestinal microorganisms.