DEOXYCHOLIC-ACID IN GALL-BLADDER BILE DOES NOT ACCOUNT FOR THE SHORTENED NUCLEATION TIME IN PATIENTS WITH CHOLESTEROL GALL-STONES

The relations between the concentration of deoxycholic acid (DCA), the cholesterol saturation index, and the nucleation time in gall bladder bile were measured to determine the role of DCA in bile in the pathog enesis of cholesterol gall stone disease. Bile was obtained from patie nts with cholesterol gall stones (n = 30), subjects without gall stone s (n = 35), and patients with pigment gall stones (n = 9). Three of 30 cholesterol gall stone patients and 10 of 35 gall stone free subjects were treated with antibiotics by mouth to decrease the concentration of bile DCA and determine the effect of DCA on biliary lithogenecity. Both the percentage and concentration of DCA in bile were similar in p atients with and without cholesterol gall stones despite significant d ifferences in their cholesterol saturation indices and nucleation time s. Neither the percentage nor the concentration of DCA in bile correla ted with either the cholesterol saturation index or the nucleation tim e. Analysis of subgroups with matching cholesterol saturation indices showed no correlation between the proportion of DCA in the bile and th e cholesterol nucleation time. The proportion of DCA in bile was decre ased by antibiotic treatment, but this had no effect on the cholestero l saturation index or nucleation time. These results suggest that DCA in bile is not responsible for biliary cholesterol saturation or chole sterol nucleation time.