Effect of portacaval shunt on serum bile acid concentration in patients with cirrhosis.

A retrospective study was carried out to examine the influence of portacaval shunt (PCS) on serum bile acid concentration in 47 cirrhotic patients. Cirrhotic patients with PCS had a significantly higher serum bile acid concentration than cirrhotic patients without PCS whatever the duration between the diagnosis and the time of measurement. Serum bile acid concentration was significantly higher 3--12 months after PCS (67.90 +/- SD 15.90 micrometer; p less than 0.001) and 12 months or more after PCS (94.11 +/- SD 33.86 micrometer; p less than 0.001) than before the shunt (18.98 +/- SD 13.62 micrometer). The mean concentration 12 months or more after PCS was significantly higher than that found 3--12 months after shunt (p less than 0.02). This progressive increase in serum bile acid concentration may indicate a deterioration of hepatic function in shunted patients.