Altered Gallbladder Bile Acidification with Long-Term Total Parenteral Nutrition

Dawes, Lillian G.; Greiner, MaryAnne; Joehl, Raymond J.

doi:10.1006/jsre.1998.5492

Cited by 11 publications

(5 citation statements)

References 34 publications

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“…Since prolonged postoperative fasting and TPN are associated with an increased incidence of biliary sludge and gallstone formation [18][19][20] , the perioperative status of patients with surgery for gastric cancer was compared between the gallstone and non-gallstone groups. However, no signifi cant difference was noted in the duration of fasting or TPN.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Study of Cholelithiasis following Gastric Cancer Surgery

Nakamura

Ogoshi²,

Makuuchi³

2005

Eur Surg Res

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The purpose of this study was to compare liver function tests preoperatively and postoperatively in 2 cohorts of patients, those that developed gallstones after gastrectomy for cancer and those that did not develop gallstones. The cohorts were taken from 698 consecutive patients who underwent curative gastrectomy for gastric cancer between April 1980 and March 1995. In comparison with 698 patients, the gallstone group was characterized by the findings that the incidence of cholelithiasis was significantly higher in totally-gastrectomized patients and patients with upper stomach cancer. Comparison of the perioperative status revealed a significantly higher rate of complications in the gallstone patients. Analysis of the changes in liver function showed significantly higher values of glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, and alkaline phosphatase at time points of 1 and 3 months after surgery in the gallstone patients. The results suggest that the postoperative development of liver dysfunction and complications is associated with the formation of gallstones.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological Study of Cholelithiasis following Gastric Cancer Surgery

Nakamura

Ogoshi²,

Makuuchi³

2005

Eur Surg Res

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“…In addition, in miniswine TPN has been found to reduce the physiological mechanism of bile acidification, which is known to inhibit the precipitation of calcium and bilirubin. 15 …”

Section: Biliary Sludgementioning

confidence: 99%

Review article: hepatobiliary complications associated with total parenteral nutrition

Angélico

Guardia

2000

Aliment Pharmacol Ther

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Summary Parenteral nutrition is often associated with hepatobiliary complications. Hepatic steatosis, intrahepatic cholestasis and biliary sludge are the most frequent. Cholestasis predominates in infants, steatosis in adults, and biliary sludge in both. Other less frequent complications are steatohepatitis and gallstones. All hepatobiliary complications are more likely to occur after extended periods of total parenteral nutrition, and are prevented by the concomitant consumption of nutrients by the enteral route. The pathogenic causes are multiple and only partially known. They include lack of gastrointestinal stimuli for biliary secretion and gall‐bladder motility, abnormalities in bile acid metabolism, the presence of sepsis, and the potentially unfavourable effects of individual components in the total parenteral nutrition formulae, including an excess of calories. Each potential mechanism and its clinical relevance is discussed in this review.

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“…Decreased oral intake or the lack enteral feeding and the use of long-term PN predispose patients to sludge and cholelithiasis formation by promoting stasis in the biliary tree ( 13 ). A previous study reported that 25–38% of patients receiving long-term PN developed symptomatic or asymptomatic cholelithiasis ( 4 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

Prevalence, Risk Factors, and Complications of Cholelithiasis in Adults With Short Bowel Syndrome: A Longitudinal Cohort Study

et al. 2021

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Background: Patients with short bowel syndrome (SBS) are at a high risk of cholestasis or cholelithiasis. This study aimed to determine the incidence, risk factors, and clinical consequences of cholelithiasis in adults with SBS over an extended period.Methods: All eligible adults diagnosed with SBS and admitted to a tertiary hospital center between January 2010 and December 2019 were retrospectively identified from the hospital records database. Kaplan–Meier analysis was used to estimate the cumulative incidence of SBS during the 10-year period. For assessment the risk factors for cholelithiasis, we used multivariate Cox proportional hazards model with estimation of hazard ratio (HR) with 95% confidence intervals (95 %CI).Results: This study enrolled 345 eligible patients with SBS. Kaplan–Meier analysis revealed that 72 patients (20.9%) developed cholelithiasis during the 10-year observation period. In multivariate analyses using the Cox proportional hazard model revealed that the remnant jejunum (HR = 2.163; 95% confidence interval [CI]: 1.156–4.047, p = 0.016) and parenteral nutrition dependence (HR = 1.783; 95% CI: 1.077–2.952, p = 0.025) were independent risk factors for cholelithiasis in adults with SBS. Twenty-eight patients developed symptoms and/or complications in the cholelithiasis group. Proportions of acute cholecystitis or cholangitis and acute pancreatitis were significantly increased in the cholelithiasis group compared with the non-cholelithiasis group (31.9 vs. 7.7%, p < 0.01; and 6.9 vs. 1.1%, p = 0.003, respectively).Conclusion: Because of the adverse clinical consequences of cholelithiasis, adult patients with SBS should be closely monitored, and preventive interventions should be considered.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04867538.

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Altered Gallbladder Bile Acidification with Long-Term Total Parenteral Nutrition

Cited by 11 publications

References 34 publications

Clinicopathological Study of Cholelithiasis following Gastric Cancer Surgery

Clinicopathological Study of Cholelithiasis following Gastric Cancer Surgery

Review article: hepatobiliary complications associated with total parenteral nutrition

Prevalence, Risk Factors, and Complications of Cholelithiasis in Adults With Short Bowel Syndrome: A Longitudinal Cohort Study

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