Study Of Stone-formation Relevant Factors In Bile Samples Collected From Patients Receiving Choledochojejunostomy

【Objective】 To observe stone-formation relevant factors changes in bile samples collected from patients receiving choledochojejunostomy and explore such change’s contribution to stone formation.【Methods】 Altogether 40 cases were recruited into this study. Twenty cases undergoing cholangioenterostomy procedure were considered as objective group(OG), with bile samples collected via T tube inserted intraoperatively crossing bile duct-intestine anastomosis. The other 20 cases receiving laparoscopic cholecystectomy for gallbladder polyps were regarded as control group(CG) and bile samples collected via gallbladder cystic duct stump during operation. Patients in CG had no evidence of concomitant inflammatory features with final confirmed pathological diagnosis of simple gallbladder polyps. Data of stone-formation relevant factors were collected, which included levels of total bilirubin, direct bilirubin, indirect bilirubin, total bile acid, total cholesterol, mucin protein, β-glucuronidase enzyme, Ca2+(calcium ion) concentration and positive rates of bile germiculture. Further comparisons were conducted between OG and CG.【Results】 Levels of several factors decreased statistically significantly in OG than those in CG, revealing total bilirubin(204.01±61.06)umol/L vs.(674.68±162.68)umol/L, direct bilirubin(138.78 ± 40.24)umol/L vs.(441.13±94.30)umol/L, indirect bilirubin(65.23±21.22)umol/L vs.(233.56±71.96)umol/L,total cholesterol(1.16± 0.27) mmol/L vs.(3.01±0.87) mmol/L, mucin protein(4.43±1.42)ug/L vs.(6.29±2.04) ug/L and Ca2+ concentration(0.80±0.23) mmol/L vs.(1.98 ± 0.64)mmol/L(P<0.05, P<0.05, P<0.05, P<0.05, P<0.05, P<0.05).While level of total bile acid in OG was higher dramatically than that in CG, demonstrating(633.06±89.82) umol/L vs.(474.89±75.21) umol/L, the difference also arrived at statistical significance( P<0.05). No difference in β-Glucuronidases level was observed between OG(1.95±0.56) U/L and CG(2.08±0.64) U/L(P>0.05). Positive rates of bile germiculture in OC were 35%, while that in CG was 0%.【Conclusion】 1.Cholangioenterostomy procedure probably does not contribute to, even to some extent, correlates negatively with early formation or recurrence of bile duct stones. 2. Although bile germiculture positivity was observed in some patients, not all patents, even 2-3 months after cholangioenterostomy, our study did not imply enough correlation with bile duct stones formation orrecurrence, which needs to be further determined.