The effect of 24-hours continuous
somatostatin-14 infusion on the volume of the bile secretion and on the bile composition were studied in seven patients with malignant biliary obstruction who had transhepatic external biliary drainage. The
bile acid composition was measured with high performance liquid chromatography (HPLC).
Somatostatin infusion significantly reduced the daily bile loss from median 473 ml to 140 ml (41 per cent, p = 0.01) with a concomitant significant reduction in the daily molar loss of
cholesterol,
triglyceride, Na+, K+, Cl-, Ca+2 and Mg+2. The loss of
chloride and
sodium was reduced with median 50 mmol/day each (p = 0.01). The relative concentrations of the measured bile constituents did not change significantly, except for
bile acids (p = 0.02): the concentration of
glycochenodeoxycholic acid increased significantly (p = 0.04). The molar loss of
taurocholic acid decreased significantly (p = 0.035), so the increased concentration of
glycochenodeoxycholic acid resulted only in a marginally significant reduction in the total molar loss of bile
aids (p = 0.051).
Somatostatin is a potent inhibitor of bile secretion. The
peptide may be used in severely bile depleted patients for reducing their serious
electrolyte and acidity problems. Analysis of
bile acid composition by HPLC is well suited for further investigations of the regulatory mechanisms of
bile acid secretion.