Effect of bile diversion and sphincterotomy on gallbladder muscle contractility and gallstone formation

Article Abstract:

It is believed that decreased contractility of the muscle of the gallbladder may result in the formation of gallstones. In prairie dogs it has been shown that sphincterotomy (incision into the muscles of the sphincter, or muscular opening, that controls the flow of bile from the gallbladder) prevents the formation of gallstones, possibly by preventing stagnation of bile in the gallbladder. A study was undertaken on prairie dogs to determine if this beneficial effect of sphincterotomy is directly due to diversion of bile or if the bile diversion maintains gallbladder contractility, thus preventing a condition conducive to gallstone formation. The animals were fed a high-cholesterol diet (a stimulus to gallstone formation). In the animals that underwent sphincterotomy and bile diversion, the effect of the high-cholesterol diet was reduced or prevented; operated animals who did not undergo these procedures showed decreased gallbladder muscle contraction and they developed gallstones. These findings suggest that performing bile diversion and sphincterotomy may prevent gallstones by avoiding reduced contractility of the gallbladder. By decreasing the amount of bile that would fill the gallbladder, the muscle is not stretched and maintains greater contractility. If this is also true in humans, sphincterotomy may result in reduced formation of gallstones by maintaining gallbladder contractility and the ability of the muscle to empty the gallstone-causing bile. Studies are needed to observe gallstone formation and gallbladder contraction in humans. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Sphincter of Oddi, Oddi's sphincter, Gallbladder

---

Effect of dietary ethanol on gallbladder absorption and cholesterol gallstone formation in the prairie dog

Article Abstract:

It has recently been suggested that intake of ethanol (alcohol) prevents gallstones. How this effect may occur is not yet clear; it is possible that the protective effect of alcohol involves other steps than just cholesterol desaturation (gallstones are often composed of cholesterol). Increased absorption of water by the gallbladder is needed for formation of gallstones. It is possible that alcohol inhibits this absorption of water by the gallbladder, thus moderating cholesterol supersaturation in the gallbladder bile. A study of 18 prairie dogs was undertaken to examine this hypothesis. The animals were fed a diet containing 0.4 percent cholesterol. Half received 30 percent of their total calories from ethanol, and the other half (controls) received the same diet, except instead of alcohol they received maltose-dextrin. After three months, the gallbladders and bile were studied. All control animals had cholesterol gallstones, but none of the alcohol-fed animals had stones, although four did have cholesterol crystals. Animals given the alcohol-supplemented diets showed significantly decreased levels of cholesterol and phospholipids (containing phosphoric acid and fatty acids) in the gallbladder. Animals fed alcohol also showed a significant decrease in the absorption of water by the gallbladder. These findings suggest that alcohol protects against gallstones through its ability to cause the gallbladder to reduce its absorption of water and to change the composition of the lipids (fats) in bile. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Alcohol, Ethanol, Cholesterol metabolism

---

Complicated presentations of groin hernias

Article Abstract:

In an inguinal hernia, a portion of the intestine protrudes through the inguinal ring in the groin; in a femoral hernia, a portion of the intestine pushes through the femoral ring in the groin. The elective repair of both inguinal and femoral hernias is performed to prevent serious complications such as bowel incarceration and obstruction. Repair of these hernias is safe. To identify factors that interfere with elective repair of these hernias, a retrospective review was undertaken of 1,859 patients (over 15 years) with groin hernias. Women and all patients with femoral hernias had increased risk of complications. Surgery was performed for bowel incarceration or obstruction in 22 of 77 women with hernias and in 15 of 34 patients with femoral hernias. Patients with bowel obstruction were significantly older than patients with either uncomplicated hernia or hernia with only incarceration. Of the 25 patients with bowel obstruction, 13 (52 percent) required removal of the dead portion of bowel. Five deaths occurred in elderly patients with inguinal hernia and bowel obstruction. Gangrene of the bowel occurred only in patients with groin hernia and obstruction. These results emphasize the importance of early diagnosis and elective repair of these hernias. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Complications and side effects, Intestines, Surgery, Elective, Elective surgery, Hernia, Inguinal hernia

Similar abstracts:

• Abstracts: Interactions between gall bladder bile and mucosa; relevance to gall stone formation. Gall stones in a Danish population. Relation to weight, physical activity, smoking, coffee consumption, and diabetes mellitus
• Abstracts: The effects of 13-cis-retinoic acid and beta-carotene on cellular immunity in humans. Premalignant lesions: role of antioxidant vitamins and beta-carotene in risk reduction and prevention of malignant transformation
• Abstracts: Human immunodeficiency virus infection and indeterminate Western blot patterns: prospective studies in a low prevalence population
• Abstracts: Acute appendicitis in the preschool child. Pregnancy and cystic fibrosis. Appendicitis in cystic fibrosis

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.