Biliary secretion of bilirubin and lipids in chronic cholestatic liver disease.

Relationships between biliary bilirubin and lipid secretions were studied in patients with chronic cholestatic liver disease, mainly primary biliary cirrhosis. The bilirubin secretion rate in the patients was not significantly different from that in the controls. However, the bilirubin output per phospholipids, per bile acids, and per phospholipids plus bile acids was high, especially at low bile acid secretion rates. Thus, the bile of the patients with chronic cholestatic liver disease appears to be frequently 'supersaturated' with bilirubin. This metabolic abnormality may be associated with an increased risk of pigment stone formation in patients with cirrhosis.