scholarly journals Effect of endoscopic sphincterotomy on gall bladder bile lithogenicity and motility

Gut ◽  
1998 ◽  
Vol 42 (2) ◽  
pp. 288-292 ◽  
Author(s):  
B C Sharma ◽  
D K Agarwal ◽  
S S Baijal ◽  
T S Negi ◽  
G Choudhuri ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Endoscopic Sphincterotomy ◽  
Saturation Index ◽  
Gallstone Disease ◽  
Nucleation Time ◽  
Bile Composition ◽  
Bladder Calculi ◽  
Cholesterol Saturation ◽  
Diseased Gall Bladder ◽  
Cholesterol Saturation Index

Background—Endoscopic sphincterotomy has been shown to inhibit stone formation in the gall bladder of experimental animals.Aims—To investigate the alterations in bile composition and gall bladder motility after endoscopic sphincterotomy.Patients—A study was performed of gall bladder bile composition and gall bladder motility in patients with gallstone disease ((n = 20; age 40–60 years, median age 55 years: seven men), with gall bladder calculi (n = 12) and with diseased gall bladder (chronic inflammation) without gall bladder calculi (n = 8)), who had received endoscopic sphincterotomy for common bile duct stones. Age and sex matched disease controls comprised 20 patients with gallstone disease but without stones and an intact sphincter of Oddi (with gall bladder calculi (n = 10) and diseased gall bladder without gall bladder calculi (n = 10)).Methods—Gall bladder motility was assessed by ultrasound. Duodenal bile collected by nasoduodenal tube after stimulation of gall bladder by intravenous ceruletid infusion was analysed for cholesterol, phospholipid, and bile acid concentrations, cholesterol saturation index, and nucleation time.Results—There was a significant reduction in mean (SEM) fasting volume (12.5 (1.7) ml v 26.4 (2.5) ml; p<0.001) and mean (SEM) residual volume (4.34 (0.9) ml v14.7 (0.98) ml; p<0.001), and increase in mean (SEM) ejection fraction (65.7 (4.2)% v 43.6 (5.52)%; p<0.001) and mean (SEM) rate constant of gall bladder emptying (−0.031/min v−0.020/min; p<0.01) in patients who had been subjected to endoscopic sphincterotomy. Median nucleation time was significantly longer (17 days v 6 days; p<0.006) in treated patients. There was a reduction in total mean (SEM) lipid concentrations (6.73 (0.32) g/dlv 7.72 (0.84) g/dl; p<0.05), cholesterol (5.6 (1.5) mmol/l v 10.3 (2.23) mmol/l; p<0.001) and CSI (0.72 (0.15) v 1.32 (0.31); p<0.001). There was no significant change in mean (SEM) phospholipid (25.6 (3.5) mmol/l v23.4 (6.28) mmol/l) and bile acid (93.7 (7.31) mmol/l v105.07 (16.6) mmol/l) concentrations.Conclusions—After endoscopic sphincterotomy there was enhanced contractility of the gall bladder, accompanied by a prolongation of nucleation time and reduction in cholesterol saturation index.

scholarly journals Stability of Human Gallbladder Bile: Effect of Freezing

2001 ◽  
Vol 15 (6) ◽  
pp. 363-366 ◽  
Author(s):  
Paul Janowitz ◽  
Richard Mason ◽  
Wolfgang Kratzer
Keyword(s):  
Saturation Index ◽  
Gallbladder Bile ◽  
Needle Puncture ◽  
Nucleation Time ◽  
Human Gallbladder ◽  
Fine Needle ◽  
Cholesterol Saturation ◽  
Before And After ◽  
Cholesterol Saturation Index ◽  
Fine Needle Puncture

In the present study, the stability of the most essential biliary parameters of human gallbladder bile at -18°C was examined over several months. In 12 patients with gallstone disease (10 female, two male; 52.1±13.3 years of age), bile was obtained through fine needle puncture of the gallbladder under local anesthetic. The concentrations of total lipids, cholesterol, phospholipids and bile acids, and the cholesterol saturation index and crystal appearance time were determined before and after freezing over a mean period of 4.38±2.9 months. Gallbladder bile obtained by fine needle puncture has proved to be of excellent quality. The total lipid concentration was unchanged before (8.30±4.16 g/dL) and after freezing (9.16±4.54 g/dL, P=0.6027). The biliary cholesterol, phospholipids and bile acid concentrations, and cholesterol saturation index showed no statistically significant differences before and after freezing. A significant difference arises in the context of subdivision of the group to the nucleation time. Before freezing, most patients had a nucleation time between five and eight days, which shortened to between one and four days after thawing (P=0.0100). The authors conclude that, with the exception of the nucleation time, human gallbladder bile can be stored at -18°C for four months with stability of major lipid components.

Anti-cholelithogenic effect of dietary tender cluster beans (Cyamopsis tetragonoloba) on the formation of cholesterol gallstones in mice

2014 ◽  
Vol 39 (2) ◽  
pp. 152-157 ◽  
Author(s):  
Chikkanna K. Raghavendra ◽  
Krihnapura Srinivasan
Keyword(s):  
Cholesterol Gallstone ◽  
Saturation Index ◽  
Liver Cholesterol ◽  
Cyamopsis Tetragonoloba ◽  
Cholesterol Gallstones ◽  
Lithogenic Diet ◽  
Cholesterol Saturation ◽  
Freeze Dried ◽  
Phospholipid Ratio ◽  
Cholesterol Saturation Index

Providing a lithogenic diet that contains 0.5% cholesterol to experimental mice for 10 weeks resulted in cholesterol supersaturation in gallbladder bile, which induced the formation of cholesterol gallstones. In this study, to evaluate the anti-cholelithogenic potential of dietary tender cluster bean, a freeze-dried powder of the test legume was included in the lithogenic diet at 5%, 10%, and 15%. Dietary cluster beans reduced the cholesterol gallstone incidence by 43%, 46%, and 58% at the respective doses. Dietary cluster beans markedly reduced biliary cholesterol and, hence, the cholesterol saturation index. This was corroborated by the beneficial modification of the cholesterol/phospholipid ratio and the cholesterol/bile acid ratio in the bile. Dietary cluster beans countered the alterations in serum and liver cholesterol and lipid profiles caused by the lithogenic diet. Thus, dietary tender cluster beans exerted an anti-cholelithogenic influence by decreasing cholesterol hypersecretion into bile and, hence, the cholesterol saturation index, decreasing the formation of lithogenic bile in experimental mice.

scholarly journals Biliary Polyunsaturated Fatty Acids and Telocytes in Gallstone Disease

2017 ◽  
Vol 26 (1) ◽  
pp. 125-133 ◽  
Author(s):  
Artur Pasternak ◽  
Jolanta Bugajska ◽  
Mirosław Szura ◽  
Jerzy A. Walocha ◽  
Andrzej Matyja ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Polyunsaturated Fatty Acids ◽  
Current Knowledge ◽  
Gallstone Disease ◽  
Gallbladder Wall ◽  
Gallbladder Bile ◽  
Gallbladder Motility ◽  
Bile Composition ◽  
Cholesterol Saturation

It has been reported that intake of ω-3 polyunsaturated fatty acids (PUFAs) reduces the risk of coronary heart disease. It also influences bile composition, decreasing biliary cholesterol saturation in the bile of patients with gallstones. In addition to bile composition disturbances, gallbladder hypomotility must be a cofactor in the pathogenesis of cholelithiasis, as it leads to the prolonged nucleation phase. Our current knowledge about gallbladder motility has been enhanced by the study of a population of newly described interstitial (stromal) cells—telocytes (TCs). The purpose of this study was to determine whether TC loss, reported by our team recently, might be related to bile lithogenicity, expressed as cholesterol saturation index or the difference in biliary PUFA profiles in patients who suffer from cholecystolithiasis and those not affected by this disease. We determined biliary lipid composition including the fatty acid composition of the phospholipid species in bile. Thus, we investigated whether differences in biliary fatty acid profiles (ω-3 PUFA and ω-6 PUFA) in gallbladder bile may influence its lithogenicity and the quantity of TCs within the gallbladder wall. We conclude that the altered PUFA concentrations in the gallbladder bile, with elevation of ω-6 PUFA, constitute important factors influencing TC density in the gallbladder wall, being one of the possible pathophysiological components for the gallstone disease development. This study established that altered bile composition in patients with cholelithiasis may influence TC quantity within the gallbladder muscle, and we concluded that reduction in TC number may be a consequence of the supersaturated bile toxicity, while some other bile components (ω-3 PUFA, glycocholic, and taurocholic acids) may exert protective effects on TC and thus possibly influence the mechanisms regulating gallbladder and extrahepatic bile duct motility. Thus, ω-3 PUFA may represent a possible option to prevent formation of cholesterol gallstones.

Effects of fluvastatin on biliary lipids in subjects with an elevated cholesterol saturation index

2001 ◽  
Vol 56 (12) ◽  
pp. 873-879 ◽  
Author(s):  
Mustafa Porsch-Özçürümez ◽  
Philip Daniel Hardt ◽  
Henning Schnell-Kretschmer ◽  
Klaus von Bergmann ◽  
Cyrill Darui ◽  
...  
Keyword(s):  
Saturation Index ◽  
Biliary Lipids ◽  
Cholesterol Saturation ◽  
Elevated Cholesterol ◽  
Cholesterol Saturation Index
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