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Changes in gallbladder bile composition following gallstone formation and weight reduction

Shiffman, Mitchell L., Sugerman, Harvey J., Kellum, John M., Moore, Edward W.·1992·Gastroenterology
DOI 10.1016/0016-5085(92)91115-k
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Abstract

Changes in gallbladder bile composition that occurred in patients who developed gallstones during weight reduction were evaluated. Bile was sampled directly from the gallbladder in 11 morbidly obese patients with no gallstones at the time of gastric bypass surgery and after gallstones had formed at cholecystectomy. Bile salt concentration ([BS]) increased significantly from a mean of 82.7-157.7 mmol/L (P less than 0.05). The concentration of cholesterol in gallbladder bile increased slightly and cholesterol saturation declined slightly with weight reduction and gallstone formation. Gallbladder mucin concentration increased 18-fold from a mean of 62 to 1110 micrograms/mL (P less than 0.001). Both free [Ca2+] and total calcium [Ca] increased 40% from mean values of 1.12 and 5.05 mmol/L at gastric bypass to 1.86 and 8.60 mmol/L after gallstone formation (P less than 0.05). The increase in [Ca2+] observed after gallstone formation was much greater than anticipated from changes in [BS] alone. This excess [Ca2+] in gallbladder bile increased curvilinearly with increasing mucin concentration. These results show that both gallbladder mucin and [Ca2+] increase with gallstone formation in humans and that mucin may modulate [Ca2+] in gallbladder bile.

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  • Moderate (4.5-8.5 kg) and severe (≥9 kg) fluctuations in a single weight cycle increase the risk of cholecystectomy by 31% and 68%, respectively.

    “Syngal et al. [35] observed both moderate (4.5-8.5 kg) and severe (≥9 kg) fluctuations in a single weight cycle to increase the risk of cholecystectomy by 31 and 68%, respectively.”

    From Excess Body Weight and Gallstone Disease (2021) · cites this paper as [35]

  • Weight cycling is an independent risk factor for gallstones.

    “Weight cycling (i.e., weight that is lost and regained) is an independent risk factor for gallstones [34][35][36].”

    From Excess Body Weight and Gallstone Disease (2021) · cites this paper as [35]

  • Weight fluctuations increase the risk of requiring a cholecystectomy.

    “Weight fluctuations also increase the risk of requiring a cholecystectomy [35].”

    From Excess Body Weight and Gallstone Disease (2021) · cites this paper as [35]

  • 35-38% of patients with morbid obesity develop gallstones as they lose weight after bariatric surgery.

    “In addition, 35–38% of patients with morbid obesity develop gallstones as they lose weight after bariatric surgery.5,14,15”

    From Gallstone Formation Prophylaxis After Gastric Restrictive Procedures for Weight Loss: A Randomized Double-Blind Placebo-Controlled Trial (2003) · cites this paper as [15]

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Research works printed but not linked: 43

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Metadata

Authors
Shiffman, M. L., Sugerman, H. J., Kellum, J. M., & Moore, E. W.
Venue
Gastroenterology
Publisher
Elsevier BV
Published
1992-07
Volume
103
Issue
1
Pages
214-221
ISSN
0016-5085
DOI
10.1016/0016-5085(92)91115-k
Cited by
125
References
0
Language
en
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)

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