Intermittent Secretion of Abnormal Bile in Patients with Cholesterol Gall Stones

Overview

Journal Br Med J

Specialty General Medicine

Date 1972 Nov 4

PMID 5083887

Citations 11

Authors

R A Smallwood

P Jablonski

J M Watts

Affiliations

Soon will be listed here.

Abstract

Gall bladder and hepatic bile was sampled from 66 patients undergoing elective operations on the biliary tract. Fifty-one patients had cholesterol gall stones but only 59% of these were found to have bile which was supersaturated with cholesterol. Repeated sampling of hepatic bile from patients with T-tubes showed that the secretion of supersaturated bile was intermittent.These results indicate that it is impossible to separate patients with cholesterol stones from controls simply by examination of the lipid composition of their bile, since an appreciable number of bile samples from patients with cholesterol stones were unsaturated.The fact that cholesterol gall stones form when the bile is supersaturated with cholesterol only intermittently suggests that the gall bladder may also have a part in their formation.

Citing Articles

Mucin and phospholipids determine viscosity of gallbladder bile in patients with gallstones.

Jungst D, Niemeyer A, Muller I, Zundt B, Meyer G, Wilhelmi M World J Gastroenterol. 2002; 7(2):203-7.

PMID: 11819761 PMC: 4723523. DOI: 10.3748/wjg.v7.i2.203.

Editorial: Determination of the cholesterol saturation of human bile and its relevance to gallstone formation.

Gregory D, VLAHCEVIC Z, SWELL L Am J Dig Dis. 1974; 19(3):268-70.

PMID: 4825579 DOI: 10.1007/BF01072545.

Bile salt metabolism in patients with gallstones in functioning gallbladders.

Pomare E, Heaton K Gut. 1973; 14(11):885-90.

PMID: 4761609 PMC: 1412843. DOI: 10.1136/gut.14.11.885.

Annual review of surgery 1972.

Ellis H Postgrad Med J. 1973; 49(575):644-55.

PMID: 4596621 PMC: 2495762. DOI: 10.1136/pgmj.49.575.644.

Variation in hepatic bile composition following cholecystectomy in patients with previous gallstones.

Boyer J, Bloomer J, Maddrey W, TILSON D Yale J Biol Med. 1974; 47(4):211-7.

PMID: 4456833 PMC: 2595121.

References

Hofmann A, Small D . Detergent properties of bile salts: correlation with physiological function. Annu Rev Med. 1967; 18:333-76. DOI: 10.1146/annurev.me.18.020167.002001. View

Iwata T, Yamasaki K . ENZYMATIC DETERMINATION AND THIN-LAYER CHROMATOGRAPHY OF BILE ACIDS IN BLOOD. J Biochem. 1964; 56:424-31. DOI: 10.1093/oxfordjournals.jbchem.a128013. View

Nakayama F, Van der Linden W . Bile from gallbladder harbouring gallstone: can it indicate stone formation?. Acta Chir Scand. 1970; 136(7):605-10. View

SWELL L, BELL Jr C, VLAHCEVIC Z . Relationship of bile acid pool size to biliary lipid excretion and the formation of lithogenic bile in man. Gastroenterology. 1971; 61(5):716-22. View

Small D . Gallstones. N Engl J Med. 1968; 279(11):588-93. DOI: 10.1056/NEJM196809122791106. View

Van der Linden W . Bile acid pattern of patients with and without gallstones. Gastroenterology. 1971; 60(6):1144-5. View

Thistle J, SCHOENFIELD L . Induced alterations in composition of bile of persons having cholelithiasis. Gastroenterology. 1971; 61(4):488-96. View

Carey M, Small D . The characteristics of mixed micellar solutions with particular reference to bile. Am J Med. 1970; 49:590-608. DOI: 10.1016/s0002-9343(70)80127-9. View

Bouchier I . Gallstone formation. Lancet. 1971; 1(7702):711-5. DOI: 10.1016/s0140-6736(71)91985-4. View

10.

Small D, Rapo S . Source of abnormal bile in patients with cholesterol gallstones. N Engl J Med. 1970; 283(2):53-7. DOI: 10.1056/NEJM197007092830201. View

11.

JUNIPER Jr K, BURSON Jr E . Biliary tract studies. II. The significance of biliary crystals. Gastroenterology. 1957; 32(2):175-208; discussion, 208-11. View

12.

DAM H, Hegardt F . The relation between formation of gallstones rich in cholesterol and the solubility of cholesterol in aqueos solutions of bile salts and lecithin. Z Ernahrungswiss. 1971; 10(3):239-52. DOI: 10.1007/BF02020935. View

13.

Small D . The formation of gallstones. Adv Intern Med. 1970; 16:243-64. View

14.

Isaksson B . On the dissolving power of lecithin and bile salts for cholesterol in human bladder bile. Acta Soc Med Ups. 1954; 59(5-6):296-306. View

15.

VLAHCEVIC Z, BELL Jr C, BUHAC I, Farrar J, SWELL L . Diminished bile acid pool size in patients with gallstones. Gastroenterology. 1970; 59(2):165-73. View

16.

Thistle J, SCHOENFIELD L . Lithogenic bile among young Indian women. N Engl J Med. 1971; 284(4):177-81. DOI: 10.1056/NEJM197101282840404. View

17.

VLAHCEVIC Z, BELL Jr C, JUTTIJUDATA P, SWELL L . Bile-rich duodenal fluid as an indicator of biliary lipid composition and its applicability to detection of lithogenic bile. Am J Dig Dis. 1971; 16(9):797-802. DOI: 10.1007/BF02239307. View

18.

SARLES H, Crotte C, GEROLAMI A, Mule A, Domingo N, Hauton J . The influence of calorie intake and of dietary protein on the bile lipids. Scand J Gastroenterol. 1971; 6(2):189-91. DOI: 10.3109/00365527109180691. View

19.

Hegardt F, DAM H . The solubility of cholesterol in aqueous solutions of bile salts and lecithin. Z Ernahrungswiss. 1971; 10(3):223-33. DOI: 10.1007/BF02020933. View

20.

THUREBORN E . On the stratification of human bile and its importance for the solubility of cholesterol. Gastroenterology. 1966; 50(6):775-80. View