Effect of cholecystectomy on the role of the gall bladder in fat absorption

Krondl, A; Vavrínková, H; Michalec, C

doi:10.1136/gut.5.6.607

Cited by 25 publications

(10 citation statements)

References 14 publications

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“…If overall return of bile salt is normal, then clearly the overall secretion of bile salt into the intestine is also normal. This would explain why, in spite of a small bile salt pool, fat is digested and absorbed normally (Krondl et al, 1964;.…”

Section: Discussionmentioning

confidence: 99%

“…Together with the normal faecal fat output of cholecystectomy patients (Krondl, Vavrinkova, and Michalec, 1964), these facts suggest that after the gallbladder is removed there is no significant deficiency of bile salts in the intestine. Beyond this, little is known of the role of the gallbladder in the bile salt economy or of the effects of cholecystectomy Received for publication 7 June 1973. on the pool size and metabolism of bile salts.…”

mentioning

confidence: 83%

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The effect of cholecystectomy on bile salt metabolism

Pomare¹,

Heaton²

1973

Gut

185

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 83%

The effect of cholecystectomy on bile salt metabolism

Pomare¹,

Heaton²

1973

Gut

185

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“…Symptoms are uncommon and transitory aft er cholecystectomy and, in general, GB removal is not associated with signifi cant medical problems. Earlier studies have also shown that cholecystectomy has no major adverse eff ects on bile acid (BA) metabolism ( 11 ) and does not aff ect fat absorption ( 12 ). Although BA pool size and synthesis remain unchanged, the BA pool circulates faster, increasing the exposure of enterohepatic organs and, eventually, of peripheral tissues to a higher fl ux of BA as compared with normal individuals ( 11,13 ).…”

mentioning

confidence: 99%

Editorial : Cholecystectomy and NAFLD: Does Gallbladder Removal Have Metabolic Consequences?

Nervi

Arrese

2013

American Journal of Gastroenterology

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Pathogenesis of nonalcoholic fatty liver (NAFLD) disease and gallbladder (GB) disease secondary to cholesterol gallstones is complex, yet both conditions share similar associated risk factors, most of them related to the metabolic syndrome. Cholecystectomy, the best treatment for GB disease, is one of the most performed abdominal surgeries worldwide. In this issue of the American Journal of Gastroenterology , Ruhl and Everhart, using data from the Third United States National Health and Nutrition Examination Survey (1988 -1994), show that NAFLD is associated with cholecystectomy (odds ratio (OR) = 2.4; 1.8 -3.3), but not with gallstones (OR = 1.1; 0.84 -1.4). This fi nding suggests that cholecystectomy may itself represent a risk factor for NAFLD, which is in line with the recently undisclosed role of the GB and bile acids in systemic metabolic regulation. Thus, cholecystectomy may not be innocuous and may have a major impact on public health by contributing to NAFLD development.

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“…Large amounts of bile may be excreted through the bile duct when relatively large amounts of triglycerides enter the system. Notably, rats do not have a gallbladder [39] and do not excrete high concentrations of bile in the presence of fats and oils in the gastrointestinal tract, but instead exhibit continuous secretion of bile at a low concentration [39,44] . Therefore, in rats, we administered bile along with DHP107 to determine the effects of bile on drug absorption.…”

Section: Discussionmentioning

confidence: 99%

Absorption mechanism of DHP107, an oral paclitaxel formulation that forms a hydrated lipidic sponge phase

et al. 2016

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Paclitaxel is a most widely used anticancer drug with low oral bioavailability, thus it is currently administered via intravenous infusion. DHP107 is a lipid-based paclitaxel formulation that can be administered as an oral solution. In this study, we investigated the mechanism of paclitaxel absorption after oral administration of DHP107 in mice and rats by changing the dosing interval, and evaluated the influence of bile excretion. DHP107 was orally administered to mice at various dosing intervals (2, 4, 8, 12, 24 h) to examine how residual DHP107 affected paclitaxel absorption during subsequent administration. Studies with small-angle X-ray diffraction (SAXS) and cryo-transmission electron microscopy (cryo-TEM) showed that DHP107 formed a lipidic sponge phase after hydration. The AUC values after the second dose were smaller than those after the first dose, which was correlated to the induction of expression of P-gp and CYP in the livers and small intestines from 2 h to 7 d after the first dose. The smaller AUC value observed after the second dose was also attributed to the intestinal adhesion of residual formulation. The adhered DHP107 may have been removed by ingested food, thus resulting in a higher AUC. In ex vivo and in vivo mucoadhesion studies, the formulation adhered to the villi for up to 24 h, and the amount of DHP107 that adhered was approximately half that of monoolein. The paclitaxel absorption after administration of DHP107 was not affected by bile in the cholecystectomy mice. The dosing interval and food intake affect the oral absorption of paclitaxel from DHP107, which forms a mucoadhesive sponge phase after hydration. Bile excretion does not affect the absorption of paclitaxel from DHP107 in vivo.

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Effect of cholecystectomy on the role of the gall bladder in fat absorption

Cited by 25 publications

References 14 publications

The effect of cholecystectomy on bile salt metabolism

The effect of cholecystectomy on bile salt metabolism

Editorial : Cholecystectomy and NAFLD: Does Gallbladder Removal Have Metabolic Consequences?

Absorption mechanism of DHP107, an oral paclitaxel formulation that forms a hydrated lipidic sponge phase

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