| Background and purpose: Congenital biliary dilation(CBD) is an embryonic etiologic malformation of biliary duct commonly found in child in Asia , always associated with pancreaticobiliary mal junction(PBM). Pancreatic juice in pancreatic duct under high pressure refluxed into biliary tract from the lengthened common channel. Enriched enzymes activated by bile injured biliary tract and might induced dilation of common bile duct. Regurgitated pancreatic juice also might cause liver damage. Cirrhosis was always found especially in younger children. Metabolic abnormalities of bile acids were found in some cases. Increased second bile acids in choledochal cysts were once thought as one of the vital carcinogenic factor in gallbladder carcinoma. Without effective methods in analysis of bile acids, no detailed information could be obtained so far. In order to gain the detailed the information of the abnormal metabolism of bile acids in CBD, we intended to developed effective and quantitative methods for the analysis of bile acids in the bile and serum, and then to determine the pathogenesis in human beings.Methods:Part â… . Analysis of bile acids in biles in choledochal cysts. Research of analytic methodology: A quantitative method for the analysis of all bile acids using a high performance liquid chromatograph coupled to an evaporative light scattering detector was developed. The linearity, analytical sensitivity, detection limit, precision and recovery were evaluated. Clinical research: with the help of the developed quantitative method using HPLOELSD, the concentration of all bile acids in 19 bile samples from choledochal cysts and 8 control bile samples were determined. Likely factors involved in metabolic alteration of bile acids such as the concentration of biliary amylyse, degree of hepatic cirrhosis,type of biliary duct dilation, jaundice were evaluated. The pathogenesis of theabnormal bile acid composition and carcinogenic affects to the wall of choledochal cyst were also investigated.Part â…¡. Analysis of bile acids in serum in CBD. Research of analytic methodology: A sensitive method was founded based on high performance liquid chromatography separation coupled to an electrospray triple-quadrupole mass spectrometry (LOMS/MS). Samely the linearity, analytical sensitivity, detection limit, precision and recovery were also evaluated. Clinical research: 15 serum samples of preoperation and postoperation 7 days later and 10 postoperative serum samples 1 year later were analyzed on a C18 reverse-phase column. The possible factors which might contribute to the abnormality of metabolism of serum bile acids were too investigated. The operation of complete biliary diversion procedures to the improvement of serum bile acids profile after operation was explored as well.Results:Part â… . Analysis of bile acids in biles in choledochal cysts. Research of analytic methodology:In a single isocratic solvent system, both conjugated and unconjugated bile acids were determined simultaneously . A linear correlation over a range of bile acid concentrations (6. 25~ 100ug/ml) was observed. The recovery period for all of the analyzed bile acids was 84. 68%~114. 18%, Intra-day and inter-day precision were 1. 51%~ 9.42% and 1. 77%~6. 82%, respectively. Clinical research: The mean of total bile acids(TBA) of biles in choledochal cysts was lower than that of the control group statistically. No LCA was found in the choledochal cysts. The percentage of DCA was high in CBD but the absolute value was lower than that in control. The decrease of TBA in CBD was proportion to the severity of liver cirrhosis found during operation. The portion of GUDCA was decreased as well, which might contribute to the carcinogenesis of the wall of choledochal cyst needing proofs.Part â… .Analysis of bile acids in serum in CBD. Research of analytic methodology:In a single chromatographic run within 10 minutes, bile acids...
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