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[The effect of the external biliary diversion on cobalamin functions]
1First Department of Surgery, Toyama Medical & Pharmaceutical University, Japan.
Nihon Geka Gakkai Zasshi
|October 1, 1995
Summary
External biliary diversion can lead to significant cobalamin (vitamin B12) loss. Supplementation is recommended for long-term diversion to prevent deficiency.
Area of Science:
- Hepatology and Gastroenterology
- Biochemistry
- Clinical Nutrition
Context:
- External biliary diversion is a medical procedure.
- Obstructive jaundice can lead to elevated serum cobalamin levels.
- Bile contains significant concentrations of cobalamin.
Purpose:
- To investigate the impact of external biliary diversion on cobalamin levels and function.
- To quantify cobalamin loss through diverted bile.
- To assess experimental effects on cobalamin in liver and serum.
Summary:
- Patients with obstructive jaundice showed elevated serum cobalamin and high concentrations in diverted bile (10-80 ng/ml).
- Daily cobalamin loss via diversion ranged from 2-12 micrograms, persisting for over 30 days.
- Experimental dogs exhibited decreased serum cobalamin (31% reduction) and liver concentrations (up to 30% reduction) after eight weeks.
Impact:
- The study highlights significant cobalamin depletion due to external biliary diversion.
- Findings suggest a shift in liver cobalamin forms, with decreased DBCC and increased methylcobalamin.
- Recommends at least 10 micrograms/day of cobalamin supplementation for long-term diversion to prevent deficiency.