IN-VITRO CYTOLYTIC ACTIVITY OF GASTRIC-JUICE FROM PATIENTS WITH DIFFERENT FASTING INTRAGASTRIC BILE-ACID CONCENTRATIONS

Objective: Evaluation of the cytolytic effect of intragastric bile aci ds collected from postoperative patients with different degrees of duo denogastric reflux. Patients and methods: The study included 60 patien ts, 26 of whom had undergone cholecystectomy for gallstones (group A), while the other 34 had undergone a Billroth II gastric resection for peptic ulcer disease (group B). Intragastric bile acid concentration w as evaluated after a 12-h fast by drainage of gastric contents every 1 5 min for 1 h using a nasogastric tube. The total bile acid (TBA) conc entrations were measured by an enzymatic method. Cytotoxicity of gastr ic juice was assessed by haemolysis of human erythrocytes and expresse d as mul of gastric juice required for 50% haemolysis (C50). Results: Group B patients had higher intragastric TBA levels than those from gr oup A (P<0.05). This was paralleled by the significantly greater in vi tro cytolytic activity exhibited by gastric juice from group B compare d with group A patients (P<0.05). There was a negative correlation bet ween TBA levels in gastric juice and C50 values; there was no correlat ion between pH and C50 values. Conclusions: Our study has demonstrated that gastric juice collected from patients who have undergone cholecy stectomy or gastric resection has different cytolytic activity, and th at there is a significantly positive, but not absolute, correlation be tween the intragastric TBA concentration and lytic activity, suggestin g that other factors also interact with intragastric TBAs to determine their lytic activity.