MAXIMAL BILIARY TRANSPORT OF SULFOBROMOPHTHALEIN IN PATIENTS WITH A T-TUBE PLACED IN THE COMMON BILE-DUCT

In 19 adult patients with choledocholithiasis who were operated on, ex cretion of free and conjugated sulfobromophthalein (BSP) in the bile c ollected through a T-tube inserted in the common bile duct was determi ned. The transport maximum (T-m) for BSP was calculated by the constan t-infusion technique after an intravenous infusion of the dye at a rat e of 0.3 and 0.09 mg/kg/min for the first and second hour, respectivel y. Free and conjugated BSP were measured in blood samples obtained at 30, 40, and 50 min of each hourly-infusion period, and in bile collect ed during the first 30 min (sample A) and between 30-50 min (sample B) after starting the first BSP infusion, and during the first 30 min (s ample C) and between 30-50 min (sample D) after starting the second in fusion. No correlations between T-m of BSP and glutathione transferase activity and between T-m and bilirubin and alkaline phosphatase in se rum were found. Although there was an overall correlation between T-m of BSP and biliary excretion of BSP after 30 min of starting the BSP i nfusion (samples B, C and D) (r = 0.4716; P = 0.41), T-m values were a lways lower than recoveries of free BSP in bile. It seems that T-m of BSP (measured with the Wheeler's method) overestimates the actual valu es of biliary excretion of free BSP, and that the percentage of conjug ated BSP in serum is related to the degree of impairment of biliary tr ansport of BSP.