Supersaturated Bile - Is it Due to a Metabolic Disorder or to an Impaired Gallbladder?

Abstract

Scherstén, T., Cahlin, E., Jönsson, J., Lindblad, L. & Nilsson, Sv. Supersaturated bile - Is it due to a metabolic disorder or to an impaired gallbladder? Scand. J. Gastroent. 1974, 9, 501–506.

The biliary lipid composition of hepatic bile during varied bile acid secretion rates in 5 patients operated on for uncomplicated gallstone disease was determined. The bile acid secretion rate was varied by interruption of the enterohepatic circulation (EHC) and by duodenal refeeding of bile acids during interrupted EHC. The relationship between the bile acid secretion rate and the molar ratio between biliary cholesterol and its solubilizing lipids was determined. On the basis of these data the bile acid secretion rate at which the hepatic bile became supersaturated with cholesterol was determined (1300 ± 300 µmol/hour). In another 10 cholecystectomized patients the diurnal variation of the biliary lipid composition was studied. Night bile from patients who were fasting was supersaturated with cholesterol in all these patients. In seven of them the lipid composition and the diurnal variation were very similar. These patients secreted supersaturated bile for a mean of 13 hours out of the 24. Two patients secreted supersaturated bile throughout the 24 hours. It is concluded that the secreted hepatic bile can be supersaturated with cholesterol merely because of a low bile acid secretion rate, and that the functioning gallbladder was not essential for the continuous secretion of supersaturated bile.

Key-words::

• Bile acids
• bile cholesterol
• bile lecithins
• biliary secretion
• cholesterol gallstones
• diurnal variation
• human bile