Plasma cholecystokinin and gallbladder responses to intraduodenal fat in gallstone patients

Masclee, Ad; Jansen, J. B. M. J.; Driessen, W. M. M.; Geuskens, L.M.; Lamers, C. B. H. W.

doi:10.1007/bf01536255

Cited by 57 publications

(19 citation statements)

References 22 publications

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“…Many studies have shown that gallbladder emptying is abnormal in patients with gallstones [20][21][22][23][24][25][26][27][28][29][30][31] . In addition, it has been observed that cystic duct flow resistance is increased before gallstone formation [32,33] .…”

Section: Wwwwjgnetcommentioning

confidence: 99%

On the mechanical behavior of the human biliary system

Luo

Li²,

Bird³

et al. 2007

WJG

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This paper reviews the progress made in understanding the mechanical behaviour of the biliary system. Gallstones and diseases of the biliary tract affect more than 10% of the adult population. The complications of gallstones, i.e. acute pancreatitis and obstructive jandice, can be lethal, and patients with acalculous gallbladder pain often pose diagnostic difficulties and undergo repeated ultrasound scans and oral cholecystograms. Moreover, surgery to remove the gallbladder in these patients, in an attempt to relieve the symptoms, gives variable results. Extensive research has been carried out to understand the physiological and pathological functions of the biliary system, but the mechanism of the pathogenesis of gallstones and pain production still remain poorly understood. It is believed that the mechanical factors play an essential role in the mechanisms of the gallstone formation and biliary diseases. However, despite the extensive literature in clinical studies, only limited work has been carried out to study the biliary system from the mechanical point of view. In this paper, we discuss the state of art knowledge of the fluid dynamics of bile flow in the biliary tract, the solid mechanics of the gallbladder and bile ducts, recent mathematical and numerical modelling of the system, and finally the future challenges in the area.

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Section: Wwwwjgnetcommentioning

confidence: 99%

On the mechanical behavior of the human biliary system

Luo

Li²,

Bird³

et al. 2007

WJG

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“…So far, no convincing evidence has been reported of a role for CCK in gallstone disease. 10,14,19,20 The aim of the present study was to evaluate if there is any relationship between the dominating pathogenetic factors for gallstone development and body composition or fat distribution. Since obesity and, particularly, abdominal fat distribution is associated with disturbances in glucose and lipid metabolism, gallstone pathogenetic factors were also investigated in relation to these parameters in order to explain why some obese subjects develop gallstones and some do not.…”

Section: Introductionmentioning

confidence: 99%

Fasting gall bladder volume and lithogenicity in relation to glucose tolerance, total and intra-abdominal fat masses in obese non-diabetic subjects

et al. 1998

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OBJECTIVE: To investigate whether total body fat mass or fat distribution and associated metabolic disturbances in glucose and lipid metabolism in¯uence the well known gallstone pathogenetic factors in obese subjects in order to explain why some obese subjects develop gallstones and some do not. DESIGN: Cross sectional study of gallstone pathogenetic factors, body composition, fat distribution, glucose and lipid metabolism. SUBJECTS: 57 healthy overweight subjects (aged 26±64 y, body mass index (BMI) 30±45 kg/m 2 ). MEASUREMENTS: Total and intra-abdominal fat masses were measured by dual X-ray absorptiometry and abdominal CT scanning, respectively. The lithogenic index was measured in aspirated bile. The gallbladder volume was determined by ultrasound and the gallbladder ejection fraction% by dynamic cholescintigraphy. Plasma cholecystokinin (CCK) concentrations during a meal were measured with a speci®c radioimmunoassay. Insulin sensitivity was measured by the Minimal Model and glucose tolerance by an oral glucose tolerance test (OGTT). Serum lipid concentrations were measured by standard methods. RESULTS: The gallbladder volume in the fasting state increased with increasing intra-abdominal fat mass (P 0.006) and was increased in subjects with impaired glucose tolerance (41 vs 27 ml, P 0.001). The lithogenic index was b 1 in all subjects and correlated with total fat mass (P 0.04). CONCLUSION: Gallstone pathogenesis in obesity seems to be in¯uenced by the total body fat mass and its regional distribution possibly via mutual association with the glucose tolerance.

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“…Our study does not show differ ences in the maximum contraction, but rather in the sensitivity because it compares two groups of gallbladders: one with stones having an average cholesterol content of 94% (radiolucent gallstones) and the other with stones in which calcium is present (radi opaque gallstones) and whose cholesterol content is clearly greater than 3.5%, varying between 50 and 63%. Studies in the litera ture of in vivo gallbladder motility have focussed on a group of patients with stones that had a reduced sensitivity either to CCK or to fat meal (12,13]. Our in vitro study, while confirming altered sensitivity in vivo to neurohormonal stimuli, uses final concen trations of CCK-OP that are 1.000 times greater than plasma concentration.…”

Section: Discussionmentioning

confidence: 95%

In vitro Gallbladder Motility in Patients with Radiolucent and Radiopaque Stones

et al. 1991

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Twenty-five gallbladders were studied in vitro. Sixteen had radiolucent gallstones and 9 had radiopaque gallstones. The radiolucent gallstones had a cholesterol content of 94.17 ± 3.76% and the radiopaque gallstones had a cholesterol content of 56.6 ± 4.46%. Half the maximal response (ED₅₀) to cholecystokinin octapeptide (CCK-OP) and to carbachol in strips from patients with radiolucent gallstones was 0.8 ± 0.15 and 27.01 ± 3.74 × 10^-7M, respectively. In strips from patients with radiopaque gallstones, the ED⁵⁰ was 0.4 ± 0.08 and 14.92 ± 3.07 × 10^-7M, respectively. The ED₅₀ values to CCK-OP and carbachol were greater in strips from specimens with radiolucent gallstones than in strips from specimens with radiopaque gallstones (p < 0.05). There was no significant difference in the maximal contractile response of the two groups. It can be concluded that gallbladder sensitivity to CCK-OP and carbachol can be modified in relation to differences in the cholesterol and calcium content of the stones.

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Plasma cholecystokinin and gallbladder responses to intraduodenal fat in gallstone patients

Cited by 57 publications

References 22 publications

On the mechanical behavior of the human biliary system

On the mechanical behavior of the human biliary system

Fasting gall bladder volume and lithogenicity in relation to glucose tolerance, total and intra-abdominal fat masses in obese non-diabetic subjects

In vitro Gallbladder Motility in Patients with Radiolucent and Radiopaque Stones

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