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Effect of endoscopic sphincterotomy on gall bladder bile lithogenicity and motility.
Gut 1998; 42(2):288-92Gut

Abstract

BACKGROUND

Endoscopic sphincterotomy has been shown to inhibit stone formation in the gall bladder of experimental animals.

AIMS

To investigate the alterations in bile composition and gall bladder motility after endoscopic sphincterotomy.

PATIENTS

A study was performed of gall bladder bile composition and gall bladder motility in patients with gallstone disease ((n = 20; age 40-60 years, median age 55 years: seven men), with gall bladder calculi (n = 12) and with diseased gall bladder (chronic inflammation) without gall bladder calculi (n = 8)), who had received endoscopic sphincterotomy for common bile duct stones. Age and sex matched disease controls comprised 20 patients with gallstone disease but without stones and an intact sphincter of Oddi (with gall bladder calculi (n = 10) and diseased gall bladder without gall bladder calculi (n = 10)).

METHODS

Gall bladder motility was assessed by ultrasound. Duodenal bile collected by nasoduodenal tube after stimulation of gall bladder by intravenous ceruletid infusion was analysed for cholesterol, phospholipid, and bile acid concentrations, cholesterol saturation index, and nucleation time.

RESULTS

There was a significant reduction in mean (SEM) fasting volume (12.5 (1.7) ml v 26.4 (2.5) ml; p < 0.001) and mean (SEM) residual volume (4.34 (0.9) ml v 14.7 (0.98) ml; p < 0.001), and increase in mean (SEM) ejection fraction (65.7 (4.2)% v 43.6 (5.52)%; p < 0.001) and mean (SEM) rate constant of gall bladder emptying (-0.031/min v -0.020/min; p < 0.01) in patients who had been subjected to endoscopic sphincterotomy. Median nucleation time was significantly longer (17 days v 6 days; p < 0.006) in treated patients. There was a reduction in total mean (SEM) lipid concentrations (6.73 (0.32) g/dl v 7.72 (0.84) g/dl; p < 0.05), cholesterol (5.6 (1.5) mmol/l v 10.3 (2.23) mmol/l; p < 0.001) and CSI (0.72 (0.15) v 1.32 (0.31); p < 0.001). There was no significant change in mean (SEM) phospholipid (25.6 (3.5) mmol/l v 23.4 (6.28) mmol/l) and bile acid (93.7 (7.31) mmol/l v 105.07 (16.6) mmol/l) concentrations.

CONCLUSIONS

After endoscopic sphincterotomy there was enhanced contractility of the gall bladder, accompanied by a prolongation of nucleation time and reduction in cholesterol saturation index.

Authors+Show Affiliations

Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9536957

Citation

Sharma, B C., et al. "Effect of Endoscopic Sphincterotomy On Gall Bladder Bile Lithogenicity and Motility." Gut, vol. 42, no. 2, 1998, pp. 288-92.
Sharma BC, Agarwal DK, Baijal SS, et al. Effect of endoscopic sphincterotomy on gall bladder bile lithogenicity and motility. Gut. 1998;42(2):288-92.
Sharma, B. C., Agarwal, D. K., Baijal, S. S., Negi, T. S., Choudhuri, G., & Saraswat, V. A. (1998). Effect of endoscopic sphincterotomy on gall bladder bile lithogenicity and motility. Gut, 42(2), pp. 288-92.
Sharma BC, et al. Effect of Endoscopic Sphincterotomy On Gall Bladder Bile Lithogenicity and Motility. Gut. 1998;42(2):288-92. PubMed PMID: 9536957.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of endoscopic sphincterotomy on gall bladder bile lithogenicity and motility. AU - Sharma,B C, AU - Agarwal,D K, AU - Baijal,S S, AU - Negi,T S, AU - Choudhuri,G, AU - Saraswat,V A, PY - 1998/4/16/pubmed PY - 1998/4/16/medline PY - 1998/4/16/entrez SP - 288 EP - 92 JF - Gut JO - Gut VL - 42 IS - 2 N2 - BACKGROUND: Endoscopic sphincterotomy has been shown to inhibit stone formation in the gall bladder of experimental animals. AIMS: To investigate the alterations in bile composition and gall bladder motility after endoscopic sphincterotomy. PATIENTS: A study was performed of gall bladder bile composition and gall bladder motility in patients with gallstone disease ((n = 20; age 40-60 years, median age 55 years: seven men), with gall bladder calculi (n = 12) and with diseased gall bladder (chronic inflammation) without gall bladder calculi (n = 8)), who had received endoscopic sphincterotomy for common bile duct stones. Age and sex matched disease controls comprised 20 patients with gallstone disease but without stones and an intact sphincter of Oddi (with gall bladder calculi (n = 10) and diseased gall bladder without gall bladder calculi (n = 10)). METHODS: Gall bladder motility was assessed by ultrasound. Duodenal bile collected by nasoduodenal tube after stimulation of gall bladder by intravenous ceruletid infusion was analysed for cholesterol, phospholipid, and bile acid concentrations, cholesterol saturation index, and nucleation time. RESULTS: There was a significant reduction in mean (SEM) fasting volume (12.5 (1.7) ml v 26.4 (2.5) ml; p < 0.001) and mean (SEM) residual volume (4.34 (0.9) ml v 14.7 (0.98) ml; p < 0.001), and increase in mean (SEM) ejection fraction (65.7 (4.2)% v 43.6 (5.52)%; p < 0.001) and mean (SEM) rate constant of gall bladder emptying (-0.031/min v -0.020/min; p < 0.01) in patients who had been subjected to endoscopic sphincterotomy. Median nucleation time was significantly longer (17 days v 6 days; p < 0.006) in treated patients. There was a reduction in total mean (SEM) lipid concentrations (6.73 (0.32) g/dl v 7.72 (0.84) g/dl; p < 0.05), cholesterol (5.6 (1.5) mmol/l v 10.3 (2.23) mmol/l; p < 0.001) and CSI (0.72 (0.15) v 1.32 (0.31); p < 0.001). There was no significant change in mean (SEM) phospholipid (25.6 (3.5) mmol/l v 23.4 (6.28) mmol/l) and bile acid (93.7 (7.31) mmol/l v 105.07 (16.6) mmol/l) concentrations. CONCLUSIONS: After endoscopic sphincterotomy there was enhanced contractility of the gall bladder, accompanied by a prolongation of nucleation time and reduction in cholesterol saturation index. SN - 0017-5749 UR - https://www.unboundmedicine.com/medline/citation/9536957/Effect_of_endoscopic_sphincterotomy_on_gall_bladder_bile_lithogenicity_and_motility_ L2 - http://gut.bmj.com/cgi/pmidlookup?view=long&amp;pmid=9536957 DB - PRIME DP - Unbound Medicine ER -