Mucin and phospholipids determine viscosity of gallbladder bile in patients with gallstones

Jüngst, Dieter; Niemeyer, Anna; Müller, I.; Zündt, Benedikta; Meyer, G.; Wilhelmi, Martin; Pozo, Reginald Del

doi:10.3748/wjg.v7.i2.203

Cited by 34 publications

(33 citation statements)

References 32 publications

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“…Doty [37] suggested that this was due to the presence of mucus in gallbladders with stones. Jungst et al [38] also showed that the viscosity of bile was markedly higher in patients with cholesterol (5.0 mPa.s) and mixed stones (3.5 mPa.s) compared to that of hepatic bile (0.92 mPa.s). He also found a positive correlation between mucin and viscosity in gallbladder bile but not in hepatic bile.…”

Section: Bile Rheologymentioning

confidence: 97%

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On the mechanical behavior of the human biliary system

Luo

Li²,

Bird³

et al. 2007

WJG

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This paper reviews the progress made in understanding the mechanical behaviour of the biliary system. Gallstones and diseases of the biliary tract affect more than 10% of the adult population. The complications of gallstones, i.e. acute pancreatitis and obstructive jandice, can be lethal, and patients with acalculous gallbladder pain often pose diagnostic difficulties and undergo repeated ultrasound scans and oral cholecystograms. Moreover, surgery to remove the gallbladder in these patients, in an attempt to relieve the symptoms, gives variable results. Extensive research has been carried out to understand the physiological and pathological functions of the biliary system, but the mechanism of the pathogenesis of gallstones and pain production still remain poorly understood. It is believed that the mechanical factors play an essential role in the mechanisms of the gallstone formation and biliary diseases. However, despite the extensive literature in clinical studies, only limited work has been carried out to study the biliary system from the mechanical point of view. In this paper, we discuss the state of art knowledge of the fluid dynamics of bile flow in the biliary tract, the solid mechanics of the gallbladder and bile ducts, recent mathematical and numerical modelling of the system, and finally the future challenges in the area.

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Section: Bile Rheologymentioning

confidence: 97%

“…In general, the Newtonian bile seemed to be associated with normal subjects. Increased viscosity of gallbladder bile has been considered an important factor in the pathogenesis of gallstone disease [38] . It is clear that the bile viscosity can be subjectdependent even in nor mal physiological cases.…”

Section: Bile Rheologymentioning

confidence: 99%

On the mechanical behavior of the human biliary system

Luo

Li²,

Bird³

et al. 2007

WJG

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“…Several investigators have shown that supersaturated bile is necessary for progression to cholelithiasis [3,10,13,14,46,55,56]. During pregnancy, biliary cholesterol saturation progressively increases from the first to the third trimester [56,57]. Estrogens enhance hepatic cholesterol secretion [57] and, along with progestins, reduce bile acid secretion [58^61].…”

Section: Bile and Biliary Sludgementioning

confidence: 99%

Intracellular Liposomes and Cholesterol Deposits in Chronic Cholecystitis and Biliary Sludge

Gilloteaux

Miller

2004

Ultrastructural Pathology

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“…In addition, the presence of mucus in gallbladders with stones also accounts for the differences in viscosity. 18 Jungst et al 27 showed that the biliary viscosity is markedly higher in gallbladders with cholesterol (= 5.0 mPa s) and mixed stones (= 3.5 mPa s) compared to hepatic bile (= 0.2 mPa s). A positive correlation between mucin and viscosity was found in gallbladder bile but not in hepatic bile.…”

Section: Introductionmentioning

confidence: 99%

“…Increased viscosity of gallbladder bile and its non-Newtonian behavior are thus considered to be important effects in the pathogenesis of gallstone disease. 27 It has been shown that cholecystokinin (CCK) stimulation not only causes the gallbladder to contract, but also allows the cystic and common bile ducts to contract. 15,41 However, the sensitivity to CCK decreases from gallbladder to common bile duct.…”

Section: Introductionmentioning

confidence: 99%

Non-Newtonian Bile Flow in Elastic Cystic Duct: One- and Three-Dimensional Modeling

Luo

Chin

et al. 2008

Ann Biomed Eng

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Abstract-Bile flow is thought to play an essential role in the pathophysiological genesis of cholelithiasis (gallstone formation) and in gallbladder pain. In this paper, we extend our previous study of the human biliary system (Li et al., 2007, J. Biomech. Eng., 129:164-173) to include two important factors: the non-Newtonian properties of bile, and elastic deformation of the cystic duct. A one-dimensional (1D) model is analyzed and compared with three-dimensional (3D) fluid-structure interaction simulations. It is found that non-Newtonian bile raises resistance to the flow of bile, which can be augmented significantly by the elastic deformation (collapse) of the cystic duct. We also show that the 1D model predicts the pressure drop of the cystic duct flow well for all cases considered (Newtonian or non-Newtonian flow, rigid or elastic ducts), when compared with the full 3D simulations.

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Mucin and phospholipids determine viscosity of gallbladder bile in patients with gallstones

Abstract: The viscosity of gallbladder bile is markedly higher than that of hepatic bile in patients with gallstones. The concentration of mucin is the major determinant of biliary viscosity and may contribute by this mechanism to the role of mucin in the pathogenesis of gallstones.

Cited by 34 publications

References 32 publications

On the mechanical behavior of the human biliary system

On the mechanical behavior of the human biliary system

Intracellular Liposomes and Cholesterol Deposits in Chronic Cholecystitis and Biliary Sludge

Non-Newtonian Bile Flow in Elastic Cystic Duct: One- and Three-Dimensional Modeling

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