Experimental studies on causes of calculus formation in common bile duct

    CHEN Xiaoª²Wen, ZHI Faª²Chao£¬ CAO Dongª²Lin, ZHOU Siª²Lang, CHEN Yongª²Wei, XIE Dong

    1Department of Gastroenterology, PLA 421 Hospital, Guangzhou 510310, China, 2Department of Gastroenterology, Nanfan Hospital, Guangzhou 510515, China, 3Department of Biochemistry, Southern Medical University, Guangzhou 510315, China

    ¡¾Abstract¡¿ AIM: To observe the roles of bacterial infections, gastrointestinal hormones and bile biochemical factors during calculus formation in the common bile duct. METHODS: In this study, 72 patients were divided into 2 groups: CBDS group (56 patients with common bile duct stone) and NCBDS group (16 patients with obstruction of common bile duct but without CBDS). Bile aspirated by ERCP from all the patients was cultured aerobically and the contents of TBA, Ca2+, P2+ and CHO in the bile were detected. Stones of 11 patients aspirated by ERCP were inspected for E.coli by PCR. The serum motilin (MTL) and the somatostatin (SS) were measured by radioimmunoassay in 52 patients. RESULTS: 53 patients (95%) of CBDS group and 8 patients (50%) of NCBDS group were positive in biliary germicultures. Infection rate in CBDS group was significantly higher than that in NCBDS group (P<0.05). Three (27%) of 11 patients who had a PCR examination had positive results. The serum motilin level of the patients in CBDS group was significantly lower compared with that of the patients in NCBDS group (202¡À151 vs 315¡À161) ng/L, while the serum somatostatin and bile Ca2+ level of CBDS group were significantly higher than those of NCBDS group [(15¡À5 vs 12¡À3) ng/L, (1.4¡À0.9 vs 0.7¡À0.3) mmol/L, P<0.05]. TBA level of CBDS group was significantly lower than that of NCBDS group [(12¡À6 vs 16¡À7) nmol/L, P<0.05]CONCLUSION: The changes of biochemical characteristics in the bile, the disorders of modulating action of gastrointestinal hormones and the bacterial infections may be the risk factors of common bile duct stones. ......