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Analysis of gallbladder bile in morbid obesity

Freeman, Joel B., Meyer, Paul D., Printen, Kenneth J., Mason, Edward E., DenBesten, Lawrence·1975·The American Journal of Surgery
DOI 10.1016/0002-9610(75)90292-5
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Abstract

Thirty-seven per cent of our grossly obese patients selected for gastric bypass had cholesterol gallstones. To document the composition of the biliary lipids prior to weight loss, the bile taken from eleven obese patients at the time of gastric bypass was analyzed and the results compared with those in eleven nonobese patients undergoing elective surgery. There was extreme supersaturation of both gallbladder and hepatic bile in all obese patients. The gallbladder bile of all obese patients fell well outside the micellar zone whereas the bile from all but one of the controls fell within the micellar zone. These data provide biochemical support for the clinical association of obesity and cholesterol gallstone formation and are evidence against the possibility that gastric bypass is a lithogenic operation.

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Crossref · 10.1016/0002-9610(75)90292-5

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  • Increased body fat is lithogenic, and higher body weight is associated with greater risk of cholesterol stones in the gallbladder.

    “Thus, increased body fat is lithogenic [19], and the higher the body weight, the greater the risk of cholesterol stones in the gallbladder [12].”

    From Excess Body Weight and Gallstone Disease (2021) · cites this paper as [19]

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Cites

No references could be resolved yet.

Research works printed but not linked: 21

  1. Newman, 1959, Autopsy incidence of gallstones, Int Abstr Surg, 109, 1
  2. Friedman, 1966, The epidemiology of gallbladder disease, J Chron Dis, 19, 273, 10.1016/0021-9681(66)90132-9 · DOI
  3. Printen, 1973, Gastric surgery for relief of morbid obesity, Arch Surg, 106, 428, 10.1001/archsurg.1973.01350160046007 · DOI
  4. Barber, 1973, Intestinal bypass operations for obesity, Am J Surg, 126, 669
  5. Payne, 1973, Surgical treatment of morbid obesity, Arch Surg, 106, 432, 10.1001/archsurg.1973.01350160050008 · DOI
  6. Brenneman, 1972, The formation of abnormal bile and cholesterol gallstones from dietary cholesterol in the prairie dog, J Clin Invest, 51, 1495, 10.1172/JCI106946 · DOI
  7. Admirand, 1968, The physicochemical basis of cholesterol gallstone formation in man, J Clin Invest, 47, 1043, 10.1172/JCI105794 · DOI
  8. Metzger, 1972, The lithogenic index—a numerical expression for the relative lithogenicity of bile, Gastroenterology, 62, 499, 10.1016/S0016-5085(72)80160-4 · DOI
  9. Heller, 1973, Cholesterol and bile salt studies on the bile of patients with cholesterol gallstones, Gut, 14, 83, 10.1136/gut.14.2.83 · DOI
  10. Holzbach, 1973, Cholesterol solubility in bile. Evidence that supersaturated bile is frequent in healthy man, J Clin Invest, 52, 1467, 10.1172/JCI107321 · DOI
  11. Wheeler, 1973, Pathogenesis of gallstones, Surg Clin North Am, 53, 963, 10.1016/S0039-6109(16)40129-5 · DOI
  12. Thistle, 1973, Lithogenic bile among young Indian women, N Engl J Med, 284, 177, 10.1056/NEJM197101282840404 · DOI
  13. Vlahcevic, 1972, Relationship of bile acid pool size to the formation of lithogenic bile in female Indians of the southwest, Gastroenterology, 62, 73, 10.1016/S0016-5085(72)80011-8 · DOI
  14. Metzger, 1973, Diurnal variation in biliary lipid composition, N Engl J Med, 288, 333, 10.1056/NEJM197302152880702 · DOI
  15. Nestel, 1973, Cholesterol metabolism in human obesity, J Clin Invest, 52, 2389, 10.1172/JCI107428 · DOI
  16. Caldwell, 1965, Dietary production and dissolution of cholesterol gallstones in the mouse, Am J Physiol, 209, 473, 10.1152/ajplegacy.1965.209.3.473 · DOI
  17. Sarles, 1970, Diet, cholesterol gallstones and composition of the bile, Am J Dig Dis, 15, 251, 10.1007/BF02233456 · DOI
  18. DenBesten, 1973, The effect of dietary cholesterol on the composition of human bile, Surgery, 73, 266
  19. Vlahcevic, 1970, Diminished bile acid pool size in patients with gallstones, Gastroenterology, 59, 165, 10.1016/S0016-5085(19)33757-6 · DOI
  20. Dowling, 1972, Lithogenic bile in patients with ileal dysfunction, Gut, 13, 415, 10.1136/gut.13.6.415 · DOI
  21. Thomas, 1974, The effects of gastric exclusion operations on pancreatic exocrine secretion, Surgery, 75, 461

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Metadata

Authors
Freeman, J. B., Meyer, P. D., Printen, K. J., Mason, E. E., & DenBesten, L.
Venue
The American Journal of Surgery
Publisher
Elsevier BV
Published
1975-02
Volume
129
Issue
2
Pages
163-166
ISSN
0002-9610
DOI
10.1016/0002-9610(75)90292-5
Cited by
46
References
0
Language
en
Licence

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