Effect of ursodeoxycholic acid on bile secretion after endoscopic nasobiliary drainage in patients with cholestatic liver disease of various causes / 临床肝胆病杂志

ABSTRACT

ObjectiveTo observe the effect of ursodeoxycholic acid (UDCA) on bile secretion in patients with cholestatic liver disease of various causes. MethodsA total of 48 patients who underwent endoscopic nasobiliary drainage (ENBD) in Beijing You′an Hospital Affiliated to Capital Medical University from July 2013 to May 2014 were enrolled and divided into UDCA treatment group (n=36) and control group (n=12). The patients in the UDCA group were further divided into common bile duct stone group (n=9), cholangiocarcinoma group (n=7), sclerosing cholangitis group (n=7), and post-liver transplantation group (n=13). The patients in the UDCA treatment group received oral UDCA capsules (250 mg, 3 times/day) since the second day after surgery, and the daily volume of bile drainage was recorded for 7 days after surgery. Serum levels of total bilirubin (TBil), total bile acid (TBA), gamma-glutamyl transpeptidase (GGT), and alkaline phosphatase (ALP) were measured on the day before surgery and the 7th day after surgery, and the effects of UDCA on volume of bile drainage, TBil, TBA, GGT, and ALP were compared between groups. The t-test was applied for comparison between groups, comparison of continuous data between these groups was made by analysis of variance; the chi-square test was applied for comparison of categorical data between groups. ResultsCompared with the control group, the UDCA treatment group had a significantly increased volume of bile drainage on the 3rd, 4th, and 5th days after surgery (t=2.461, 3.896, and 2.760; P=0.048, 0.021, and 0.034), and the increase in volume of bile drainage was more significant in the common bile duct stone group, the cholangiocarcinoma group, and the post-liver transplantation group, with peak values appearing on the 4th day after surgery. The patients in the common bile duct stone group and the post-liver transplantation group had significantly lower serum levels of TBil, GGT, and ALP on the 7th day after surgery (t=3.340, 2.503, and 2.158, P=0.016, 0.038, and 0045; t=2.951, 2.805, and 2.461, P=0.014, 0029, and 0.034). ConclusionUDCA can increase bile secretion and improve liver function in patients with cholestatic liver disease of various causes.