Role of gallbladder mucus in the pathogenesis of cholesterol gallstones

Jeffrey E. Doty, Henry A. Pitt, Stephen L. Kuchenbecker, Vicki Porter-Fink, Lawrence W. DenBesten

Research output: Contribution to journalArticlepeer-review

Abstract

Recent observations indicate that the hepatic secretion of lithogenic bile, gallbladder mucus hypersecretion, and gallbladder stasis are all critical factors in the pathogenesis of cholesterol gallstones. Using the prairie dog gallstone model, we investigated the interaction of these factors and the sequence in which they develop. The results of this study indicated that (1) gallbladder bile mucus concentration is elevated before cholesterol precipitation and increases progressively with the formation of cholesterol crystals, (2) cystic duct resistance increases in the presence of cholesterol crystals, and (3) agglomerates of cholesterol crystals, but not fine, sonicated crystals increase cystic duct resistance. We conclude that these alterations trigger a self-perpetuating cycle of mucus hypersecretion, cholesterol crystallization, and gallbladder stasis which culminates in the formation of cholesterol gallstones.

Original languageEnglish (US)
Pages (from-to)54-61
Number of pages8
JournalThe American Journal of Surgery
Volume145
Issue number1
DOIs
StatePublished - Jan 1983

ASJC Scopus subject areas

  • Surgery

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