Effect of Endoscopic Sphincterotomy on Bile Acid Pool Size and Bile Lipid Composition in Man

Sauerbruch, T.; Stellaard, Frans; Paumgartner, Gustav

doi:10.1159/000198935

Cited by 20 publications

(9 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…No significant changes in hepatic bile composition were found in two different studies performed in dogs 1112 Sauerbruch et al 10showed a reduction in total bile acid pool size after sphincterotomy in patients with intact gall bladders, but there was no difference in molar percentages of bile acids, cholesterol, and phospholipid or in mean CSI. Cohn et al 13showed reduction in lithogenicity with increase in lecithin and bile salts after sphincter of Oddi ablation.…”

Section: Discussionmentioning

confidence: 96%

“…However, there is no direct evidence for selective reabsorption of bile constituents; therefore the idea of alterations in gall bladder content being due to selective reabsorption of bile constituents remains speculative. Sauerbruch et al 10 reported diminution of bile acid pool after ES in patients with an intact gall bladder. However, there were no alterations in bile acid pool in patients with cholecystectomy who already have smaller total bile acid pools 10.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of endoscopic sphincterotomy on gall bladder bile lithogenicity and motility

Sharma

Agarwal

Baijal

et al. 1998

Gut

View full text Add to dashboard Cite

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)). (Gut 1998;42:288-292) Keywords: gall bladder emptying; gall bladder contractility; nucleation time; cholesterol saturation index; gallstones; endoscopic papillotomy Endoscopic sphincterotomy (ES) is widely used for the extraction of common bile duct (CBD) stones in both cholecystectomised patients and those with an intact gall bladder. Hutton et al 1 2 were the first to show in a prairie dog model that ablation of the sphincter of Oddi inhibited gallstone formation despite continued supersaturation of bile. It was further shown that ablation of the sphincter both facilitates passage of glass beads of varying sizes implanted in the canine gall bladder and improves gall bladder emptying. Methods-Gall5 Long term follow up studies of patients with gall bladders in situ after endoscopic clearance of CBD stones showed that the incidence of new stone formation was almost negligible.3 4 Isolated clinical observations suggested that ES may enhance gall bladder emptying in humans.6 7 Studies performed by Li et al 8 suggested that sphincterotomy may reduce stone formation by inhibiting the eVects of lithogenic bile on gall bladder muscle contractility and enhancing the ability of muscle to empty the lithogenic bile. Alterations in bile composition have been reported both in hepatic and gall bladder bile after sphincter ablation. [9][10][11][12][13] These experimental data suggest significant alterations in gall bladder motility and bile composition after sphincter ablation 9 and emphasise the need for a case control study on the eVect of ES on gall bladder bile composition, nucleation time, and motility in man. We therefore studied these parameters in patients who had had ES for CBD stones while having their gall bladders in situ. Materials and methodsWe studied 20 patients with intact gall bladders, who had received ES for CBD stones and had a clear CBD as shown by endoscopic retrograde cholangiopancreaticography three months before inclusion in the study. Patients with small shrunken gall bladders (fasting volume less than 5 ml) were excluded. These patients were classified into two groups: (a) those with gall bladder calculi (GS+) (n = 12; age 40-60, median age 55; ...

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Effect of endoscopic sphincterotomy on gall bladder bile lithogenicity and motility

Sharma

Agarwal

Baijal

et al. 1998

Gut

View full text Add to dashboard Cite

show abstract

“…ES does not necessarily increase the risk of cholecystitis (12)(13)(14)(15)(16)(17)(18). Gallbladder-related illness after ES may be a result of duodenobiliary reflux, bacteriobilia, or changes in bile composition and/or gallbladder motility (19)(20)(21). However, both experimental and clinical studies have demonstrated enhanced gallbladder motility after sphincterotomy (19,(22)(23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Effects of Endoscopic Papillary Balloon Dilation on Gallbladder Motility

Sugiyama

2004

Dig Dis Sci

View full text Add to dashboard Cite

We prospectively studied long-term (5 years) effects of endoscopic papillary balloon dilation (EPBD) on gallbladder motility. Thirteen patients with intact gallbladders (six with and seven without gallbladder stones) who had undergone EPBD for choledocholithiasis were enrolled in this study. Gallbladder volumes, while fasting and after dried egg yolk ingestion, were determined by ultrasonography, before and at 7 days, 1 month, and 1, 2, and 5 years after EPBD. Before EPBD, the gallbladder had a larger fasting volume and lower yolk-stimulated maximum contraction than in normal controls. Seven days after EPBD, fasting volume was decreased and maximum contraction was increased, regardless of whether the patient had gallbladder stones, showing significant differences from the pre-EPBD values. At 1 month to 5 years after EPBD, these changes were far less evident and gallbladder function did not differ significantly from baseline. EPBD does not adversely affect gallbladder motility in the long-term (5 years).

show abstract

“…Numerous physiological reasons may explain the large variation of the absolute concentrations of bile acids. An important physiological factor possibly in fluencing bile acid absorption is the motility pattern, and thus the transit time of bile acids through the small and large intestine [33], The intestinal passage of bile acids is also influenced by the function of the sphincter of Oddi and the Bauhin's valve [34], The absolute serum concen trations of the individual bile acids are further influenced by the fractional absorption by the ileocytes and the colonic mucosa, and by hepatic clearance.…”

Section: Variation O F the Mean Absolute Values As Compared With The mentioning

confidence: 99%

Variation of Serum Bile Acids in Patients with Colorectal Adenomas during a One-Year Follow-Up

Bayerdörffer¹,

Mannes

Ochsenkühn³

et al. 1994

Digestion

Self Cite

View full text Add to dashboard Cite

We were recently able to show that patients with colorectal adenomas have an increased serum level of the secondary bile acid deoxycholic acid [Bayerdörffer et al.: Gastroenterology 1993;104:145-151]. The course of individual serum bile acids was followed for 1 year in a random subgroup of these patients. The individual serum bile acids of 39 patients, 10 men with adenoma, 12 men without adenoma, 8 women with adenoma, and 9 women without adenoma, were determined at 6-month intervals by gas liquid chromatography (GC). The mean individual differences in serum bile acids between baseline and 6-month follow-up and baseline and 12-month follow-up ranged from +19 to -15 nmol/l in men with adenoma, and from + 66 to -64 nmol/l in men without adenoma. In women, the ranges were +73 to -74 nmol/l in those with adenoma and +33 to -81 nmol/l in those without adenoma. The variations of the relative percentages of the individual bile acids in the three investigations were lower than those of the absolute values. The differences between the baseline, the 6-month, and the 12-month follow-up were not significant for the major bile acids deoxycholic acid, chenodeoxycholic acid and cholic acid. The main finding, namely an increase in the serum level and the relative proportion of deoxycholic acid in men with colorectal adenomas remained unchanged throughout the follow-up. The data indicate that measurement of the bile acid pattern by GC is a useful and reproducible parameter in investigating the role of secondary bile acids in the pathogenesis of colorectal cancer.

show abstract

Effect of Endoscopic Sphincterotomy on Bile Acid Pool Size and Bile Lipid Composition in Man

Cited by 20 publications

References 11 publications

Effect of endoscopic sphincterotomy on gall bladder bile lithogenicity and motility

Effect of endoscopic sphincterotomy on gall bladder bile lithogenicity and motility

Long-Term Effects of Endoscopic Papillary Balloon Dilation on Gallbladder Motility

Variation of Serum Bile Acids in Patients with Colorectal Adenomas during a One-Year Follow-Up

Contact Info

Product

Resources

About