Patients with uncomplicated cholelithiasis acidify bile normally

Thomas H. Magnuson, Keith D. Lillemoe, Beth Ann Zarkin, Henry A. Pitt

Research output: Contribution to journalArticlepeer-review

Abstract

Reports have suggested that patients with gallstones have gallbladder bile that is less acidic and more saturated with calcium carbonate than patients without gallstones. This failure to acidify bile may play a role in the formation of gallstones. We, therefore, compared gallbladder bile pH, ionized calcium, and calcium carbonate saturation index from patients undergoing either incidental gallbladder removal (controls, n=23) or elective cholecystectomy for gallstones (n=55). Gallstones were classified as either cholesterol (n=39) or black pigment (n=16) stones. No difference in gallbladder bile pH was noted among the controls, cholesterol stone, and pigment stone patients. In addition, no difference in ionized calcium concentration or CCSI was noted among the three groups. The pH in additional patients (n=49) with acute cholecystitis, common bile duct obstruction, biliary tract infection, and cystic duct obstruction was significantly more acidic. We conclude that neither a defect in bile acidification nor increased saturation of calcium carbonate explains why human cholesterol or pigment gallstones form.

Original languageEnglish (US)
Pages (from-to)1517-1522
Number of pages6
JournalDigestive diseases and sciences
Volume37
Issue number10
DOIs
StatePublished - Oct 1992

Keywords

  • bile acidification
  • cholecystitis
  • cholelithiasis
  • pH

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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