Somatostatin Reduces Bile Secretion and Loss of Bile Constituents in Patients with External Biliary Drainage

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.