Gallbladder emptying and gallstone formation: A prospective study on gallstone recurrence

Pauletzki, Jürgen; Althaus, Rupert; Holl, Joseph; Sackmann, Michael; Paumgartner, Gustav

doi:10.1053/gast.1996.v111.pm8780583

Cited by 85 publications

(47 citation statements)

References 3 publications

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“…31,32 Furthermore, in various conditions such as pregnancy, 44 obesity, 45 and treatment with somatostatin analogues, 46 increased fasting and minimal postprandial volumes are associated with increased risk of gallstone formation. Similarly, in gallstone-susceptible male C57L inbred mice, both fasting and residual gallbladder volumes increase markedly during lithogenic diet, which is not the case in gallstone-resistant male AKR mice (van Erpecum and Wang, unpublished observations).…”

Section: Discussionmentioning

confidence: 99%

“…Although fasting and minimal postprandial gallbladder volumes are correlated, minimal postprandial volumes appear to be particularly relevant for gallstone formation and recurrence after extracorporeal shock wave lithotripsy. 31,32 In one study, the risk for gallstone recurrence was increased ninefold if minimal residual volumes exceeded 5 mL. 47 Although there was a nonsignificant trend toward smaller fasting volumes in pancreatitis patients in the current study, the differences in minimal postprandial volumes were much more pronounced (5.8 Ϯ 1.0 vs. 8.1 Ϯ 0.7 mL in the pancreatitis and symptomatic gallstone group, respectively [P ϭ .005], which was 3.2 Ϯ 0.7 mL in 23 asymptomatic gallstonefree subjects previously studied in our laboratory 32 ).…”

Section: Discussionmentioning

confidence: 99%

“…Patients were characterized as strong (minimum postprandial volume Յ6 mL) or weak (minimum postprandial volume Ͼ6 mL) contractors. 31,32 Plasma CCK Measurement. Blood samples for the measurement of CCK concentrations were collected in the fasting state and at 15-minute intervals during a 2-hour period postprandially.…”

Section: Methodsmentioning

confidence: 99%

“…The differences in minimal postprandial gallbladder volumes between both groups were much more pronounced, with markedly lower values in pancreatitis patients (5.8 Ϯ 1.0 vs. 8.1 Ϯ 0.7 mL; P ϭ .005). When patients were divided into strong (minimum postprandial volume Յ6 mL) or weak (minimum postprandial volume Ͼ6 mL) 31,32 contractors, 72% of pancreatitis patients but only 30% of symptomatic gallstone patients were strong contractors (P ϭ .004). Gallbladder volumes as a function of time after meal ingestion were significantly lower in pancreatitis patients (P Ͻ .001) (Fig.…”

Section: Biliary Protein Concentrations the Concentrations Of Varioumentioning

confidence: 99%

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Small gallstones, preserved gallbladder motility, and fast crystallization are associated with pancreatitis

et al. 2005

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Acute pancreatitis is a severe complication of gallstones with considerable mortality. We sought to explore the potential risk factors for biliary pancreatitis. We compared postprandial gallbladder motility (via ultrasonography) and, after subsequent cholecystectomy, numbers, sizes, and types of gallstones; gallbladder bile composition; and cholesterol crystallization in 21 gallstone patients with previous pancreatitis and 30 patients with uncomplicated symptomatic gallstones. Gallbladder motility was stronger in pancreatitis patients than in patients with uncomplicated symptomatic gallstones (minimum postprandial gallbladder volumes: 5.8 ؎ 1.0 vs. 8.1 ؎ 0.7 mL; P ‫؍‬ .005). Pancreatitis patients had more often sludge (41% vs. 13%; P ‫؍‬ .03) and smaller and more gallstones than patients with symptomatic gallstones (smallest stone diameters: 2 ؎ 1 vs. 8 ؎ 2 mm; P ‫؍‬ .001). Also, crystallization occurred much faster in the bile of pancreatitis patients (1.0 ؎ 0.0 vs. 2.5 ؎ 0.4 days; P < .001), possibly because of higher mucin concentrations (3.3 ؎ 1.9 vs. 0.8 ؎ 0.2 mg/mL; P ‫؍‬ .04). No significant differences were found in types of gallstones, relative biliary lipid contents, cholesterol saturation indexes, bile salt species composition, phospholipid classes, total protein or immunoglobulin (G, M, and A), haptoglobin, and ␣-1 acid glycoprotein concentrations. In conclusion, patients with small gallbladder stones and/or preserved gallbladder motility are at increased risk of pancreatitis. The potential benefit of prophylactic cholecystectomy in this patient category has yet to be explored. (HEPATOLOGY 2005;41:738-746.)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Biliary Protein Concentrations the Concentrations Of Varioumentioning

confidence: 99%

See 2 more Smart Citations

Small gallstones, preserved gallbladder motility, and fast crystallization are associated with pancreatitis

et al. 2005

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“…11 Studies in patients after extracorporeal shock-wave lithotripsy have shown that more severely impaired gallbladder emptying was associated with a higher recurrence of gallstones. 12 However, gallbladders with pigment stones do not develop defects in contraction like those seen with cholesterol gallstones. 13 Taken together, these findings suggest that impaired gallbladder motility is an important contributing factor in CGD.…”

Section: Gallbladder Motilitymentioning

confidence: 99%

Cholesterol gallstone disease: focusing on the role of gallbladder

Chen

Kong

2015

Laboratory Investigation

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Gallstone disease (GSD) is one of the most common biliary tract diseases worldwide in which both genetic and environmental factors have roles in its pathogenesis. Biliary cholesterol supersaturation from metabolic defects in the liver is traditionally seen as the main pathogenic factor. Recently, there have been renewed investigative interests in the downstream events that occur in gallbladder lithogenesis. This article focuses on the role of the gallbladder in the pathogenesis of cholesterol GSD (CGD). Various conditions affecting the crystallization process are discussed, such as gallbladder motility, concentrating function, lipid transport, and an imbalance between pro-nucleating and nucleation inhibiting proteins.

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Gallstones

Portincasa¹,

Wang²

2015

Yamada' S Textbook of Gastroenterology

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Gallbladder emptying and gallstone formation: A prospective study on gallstone recurrence

Cited by 85 publications

References 3 publications

Small gallstones, preserved gallbladder motility, and fast crystallization are associated with pancreatitis

Small gallstones, preserved gallbladder motility, and fast crystallization are associated with pancreatitis

Cholesterol gallstone disease: focusing on the role of gallbladder

Gallstones

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