The enterohepatic circulation of bile acids during continuous liquid formula perfusion of the duodenum

The enterohepatic circulation of bile acids was studied in 16 normal volunteers and 8 cholecystectomy patients during continuous liquid formula perfusion of the duodenum. The fasting bile acid pool size in the 16 normals (5.534 +/- 1.472 mmol) exceeded the circulating pool size (3.643 +/- 1.126 mmol) by 33.4% +/- 13.4. The difference between fasting and circulating pool sizes was significantly and inversely related to the percentage of the fasting pool that was emptied in the duodenum during the first perfusion hour (r = -0.76; P < 0.001). No relation was found between the circulating bile acid pool size and the calculated rate of recycling of the pool, but a strong relation was found between the cycling pool and the basal hourly bile acid outputs (2.08 +/- 0.77 mmol/hr) in the duodenum (r = 0.82; P < 0.001). In cholecystectomy patients the circulating pool size (3.30 +/- 1.39 mmol) and the basal bile acid output (1.65 +/- 0.98 mmol/hr) were slightly lower than in the normal volunteers. The bile acid pool size was not related to the cycling rate and there was a strong relation between pool size and bile acid secretion (r = 0.85; P < 0.001). As the fasting pool, measured using the method of Duane et al. (1975. J. Lipid Res. 16: 155-158), is probably overestimated by +/-14%, the remaining difference of +/-19% with the pool circulating during formula perfusion might be caused by incomplete gallbladder emptying. In these experimental conditions basal bile acid outputs reflect closely the size of the circulating bile acid pool in normals as well as in cholecystectomy patients.-Rutgeerts, P., Y. Ghoos, and G. Vantrappen. The enterohepatic circulation of bile acids during continuous liquid formula perfusion of the duodenum.