Effects of bile, infection and pressure on pancreatic duct integrity.

Ionic flux, potential difference and mucosal ultrastructure have been studied in the rat bile-pancreatic duct and the effects of pressure, bile and infection on the duct evaluated. The duct remained stable after perfusion with control solution under low pressure and high pressure produced widening of intercellular spaces only. Perfusion with a bacterial solution of Escherichia coli did not effect significant changes. Sterile human bile disturbed the integrity of the duct by increasing ionic flux, altering potential difference and producing reversible ultrastructural changes of cell oedema. High pressure increased these changes. Infected human bile under high or low pressure was by far the most toxic substance tested. Perfusion with infected bile led to irreversible duct damage and complete loss of duct integrity. Pressure and infected bile may have a role in damaging duct integrity and could thus play an integral part in the genesis of acute gallstone pancreatitis.