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The purpose of this study was to investigate the relationship between the increased serum calcium changes induced by short-term intravenous calcium infusion and the resultant subsequent changes on total and ionized calcium concentration [Ca_TOT] and [Ca＾2+]level, and on bile acid changes in the T-tube bile. Ten patients underwent cholecystectomy, common duct exploration, and T-tube insertion. Serum and biliary calcium concentration were measured over an 7-hour period, before, during, and after a 4-hour intravenous infusion of 10% calcium gluconate. During the infusion, serum total calcium[Ca_TOT] increased from 2.17±0.27 mmol/L to 2.30±0.22 mmol/L and serum free ionized calcium[Ca＾2+] increased from the preinfusion state, 1.29±0.10 mmol/L to 1.34±0.15 mmol/L. After the infusion, 60 minite later, biliary total calcium [Ca_TOT] increased from 1.54±0.23 to 1.95±0.37 mmol/L and biliary ionized calcium [Ca＾2+] increased from 1.08±0.18 to 1.20±0.09 mmol/L. When the data pooled, increased serum total calcium[Ca_TOT] showed significant correlation with serum ionized calcium[Ca＾2+] And also serum ionized calcium[Ca＾2+] correlated with biliary total calcium[Ca_TOT] And as to bile acid, increased biliary ionized calcium[Ca＾2+] related to decreased bile acid. These results support the hypothesis that calcium is freely permeable at biliary excretory system, and that serum ionized calcium level is one of the determinant elements of biliary calcium level.
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