The Value of Duodenal Drainage: Its Place in Diagnosis

In vitro investigation of the origin of echoes within biliary sludge

“…For many years clinicians have examined bile collected from patients by a tube passed perorally into the duodenum (the Meltzer-Lyon test) (13,(19)(20)(21)(22)(23)(24)(25)(26)(27). When gallbladder bile contains cholesterol crystals or calcium bilirubinate granules in moderate to large amounts, there is a strong correlation with the presence of gallstones in the gallbladder or some other abnormality, such as cholesterolosis (19)(20)(21). Even though supersaturation of bile with cholesterol is very common in humans during fasting (281, cholesterol crystals usually do not develop except in those with gallstone disease 129).…”

“…For example, both cholesterol crystals and calcium bilirubinate granules have been found in patients with hepatopancreatic disease and in patients with normal hepatobiliary function who have had unrelated disorders (13). Pigment granules alone or in combination with cholesterol crystals have been noted in patients with hepatitis and hemolytic anemia in the absence of gallstones (19,251. Precipitation of calcium bilirubinate has been identified in patients with jaundice even when the gallbladder has been normal (23).…”