Deoxycholic acid is not related to lithogenic factors in gallbladder bile

The influence of deoxycholic acid (DCA) on the factors in gallbladder bile responsible for cholesterol gallstone disease has been a controversial subj ect of discussion. This might be partially due to patient selection or inap propriate methods. Therefore, we investigated the relationship between the percentage of DCA and lithogenic factors in the gallbladder bile of patient s with cholesterol gallstones and with normal or moderately impaired gallbl adder contractility. Patients with pigment stones served as a control group . The percentage of DCA in the gallbladder bile of 20 patients with cholest erol stones (23.2% +/- 6.5%; mean +/- SD) was comparable to the DCA percent age in the gallbladder bile of 11 patients with pigment stones (26.5% +/- 8 .5%). No correlation was seen between the DCA percentage of total bile acid s and the crystal observation time, cholesterol saturation index (CSI), tot al protein value, mucin level, and amount of cholesterol in vesicles or cry stals in the total group of patients or in the subgroups with cholesterol o r pigment stones, respectively. The lack of correlation between DCA percent age and CSI was determined in native bile (r = 0.048) as well as in crystal -free bile after ultracentrifugation (r = 0.107), Our findings demonstrate that in patients with gallstones, the percentage of DCA in gallbladder bile is not related to any of the known biliary factors associated with cholest erol gallstone disease. We conclude that in patients with normal or moderat ely impaired gallbladder function, an elevated DCA level in the gallbladder bile is of minor pathophysiologic significance for the formation of choles terol gallstones.