Bile acids and microorganisms in the jejunal lumen after biliary reconstruction in dogs.

Abstract

This study evaluated the composition of various bile acids and microorganisms in the jejunal lumen after using different methods of biliary reconstruction. A Billroth I biliary reconstruction, in which the biliary tract was directly anastomosed to the alimentary tract, was performed in 16 dogs, including eight with cholecystoduodenostomy (C-D group) and eight with cholecystojejunostomy (C-J group). A Billroth II reconstruction, involving a Rouxen-Y cholecystojejunostomy (R-Y group) in which bile flowed into the jejunal limb, was made in eight dogs. Jejunal fluid samples were used for microbial culture and bile acid assay by high-performance liquid chromatography. The percentage of unconjugated bile acids in the R-Y group (9.96 +/- 2.17 percent) was significantly higher than that observed in the C-D group (0.11 +/- 0.05 percent), and that observed in the C-J group (1.05 +/- 0.72 percent) (p < 0.01). The detection rate of anaerobes was higher in the R-Y group than in the C-D and C-J groups. This study suggests that due to an increase in unconjugated bile acids after the Billroth II biliary reconstruction the function of digestion and absorption is less well preserved than after the Billroth I method.