Cholic and chenodeoxycholic acids during drainage of cholestasis in man with and without bile refeeding. Determination of serum and urinary concentrations by radioimmunoassay.

Non-sulphated conjugates of cholic (C) and chenodeoxycholic (CDC) acids in serum and total conjugates in urine were determined by radioimmunoassay during drainage of extrahepatic cholestasis in twelve patients studied under three different situations: without refeeding of bile, with refeeding after a delay of one to eight days, and with immediate refeeding. The changes in the serum concentrations and renal excretion of C and CDC varied considerably between patients, but the following general features could be discerned: In patients without bile refeeding but with external drainage, the serum concentrations and renal excretion of C and CDC decreased rapidly. In patients with delayed bile refeeding during drainage, the serum concentrations of C and CDC increased when refeeding of bile was begun but only slightly and temporarily, and no influence on renal excretion could be observed. In patients with immediate bile refeeding through an internal drainage the serum concentrations decreased slowly and renal excretion increased during the first week. These differences in the pattern of serum bile acid concentrations were not reflected in the serum concentrations of bilirubin, alkaline phosphatase, alanine aminotransferase or gamma glutamyltransferase.