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Article: Origin and fate of biliary sludge

TitleOrigin and fate of biliary sludge
Authors
Issue Date1988
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro
Citation
Gastroenterology, 1988, v. 94 n. 1, p. 170-176 How to Cite?
AbstractBiliary sludge is a collection of mucus, calcium bilirubinate, and cholesterol crystals that is usually recognized by characteristic echoes on ultrasonography. Its pathogenesis, clinical significance, and ultimate prognosis remain uncertain. We therefore studied the origin of biliary sludge ultrasonic echoes, using an ex vivo liver-gallbladder preparation, and determined the outcome of a group of patients identified to have gallbladder sludge by ultrasonography. Echoes were not generated by either an increase in the total solid concentration or by the graded addition of partially purified mucus glycoprotein. Cholesterol monohydrate crystals (> 50 μm) mixed with mucus produced echoes that were indistinguishable from gallbladder sludge observed in patients. To determine the natural evolution of gallbladder sludge in patients, we prospectively followed 96 patients found to have biliary sludge for a mean of 37.8 mo by serial ultrasound scans every 6 mo. In 17 (17.7%) biliary sludge disappeared and did not recur for at least 2 yr, in 58 patients (60.4%) biliary sludge disappeared and reappeared, and in 8 patients (8.3%) asymptomatic gallstones developed. There were 12 cholecystectomies performed: six were done for symptomatic gallstones (6.3%) and the other six for sludge associated with severe biliary pain attacks with or without recurrent acute pancreatitis. The finding of sludge represented precipitates being formed in bile. In some patients, it was a precursor form of gallstone disease.
Persistent Identifierhttp://hdl.handle.net/10722/175650
ISSN
2015 Impact Factor: 18.187
2015 SCImago Journal Rankings: 7.170
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLee, SPen_US
dc.contributor.authorMaher, Ken_US
dc.contributor.authorNicholls, JFen_US
dc.date.accessioned2012-11-26T09:00:16Z-
dc.date.available2012-11-26T09:00:16Z-
dc.date.issued1988en_US
dc.identifier.citationGastroenterology, 1988, v. 94 n. 1, p. 170-176en_US
dc.identifier.issn0016-5085en_US
dc.identifier.urihttp://hdl.handle.net/10722/175650-
dc.description.abstractBiliary sludge is a collection of mucus, calcium bilirubinate, and cholesterol crystals that is usually recognized by characteristic echoes on ultrasonography. Its pathogenesis, clinical significance, and ultimate prognosis remain uncertain. We therefore studied the origin of biliary sludge ultrasonic echoes, using an ex vivo liver-gallbladder preparation, and determined the outcome of a group of patients identified to have gallbladder sludge by ultrasonography. Echoes were not generated by either an increase in the total solid concentration or by the graded addition of partially purified mucus glycoprotein. Cholesterol monohydrate crystals (> 50 μm) mixed with mucus produced echoes that were indistinguishable from gallbladder sludge observed in patients. To determine the natural evolution of gallbladder sludge in patients, we prospectively followed 96 patients found to have biliary sludge for a mean of 37.8 mo by serial ultrasound scans every 6 mo. In 17 (17.7%) biliary sludge disappeared and did not recur for at least 2 yr, in 58 patients (60.4%) biliary sludge disappeared and reappeared, and in 8 patients (8.3%) asymptomatic gallstones developed. There were 12 cholecystectomies performed: six were done for symptomatic gallstones (6.3%) and the other six for sludge associated with severe biliary pain attacks with or without recurrent acute pancreatitis. The finding of sludge represented precipitates being formed in bile. In some patients, it was a precursor form of gallstone disease.en_US
dc.languageengen_US
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastroen_US
dc.relation.ispartofGastroenterologyen_US
dc.subject.meshAdulten_US
dc.subject.meshAnimalsen_US
dc.subject.meshBileen_US
dc.subject.meshCholelithiasis - Diagnosis - Etiologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshGallbladder - Pathologyen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshSheepen_US
dc.subject.meshUltrasonographyen_US
dc.titleOrigin and fate of biliary sludgeen_US
dc.typeArticleen_US
dc.identifier.emailLee, SP: sumlee@hku.hken_US
dc.identifier.authorityLee, SP=rp01351en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid3275565-
dc.identifier.scopuseid_2-s2.0-0023852764en_US
dc.identifier.volume94en_US
dc.identifier.issue1en_US
dc.identifier.spage170en_US
dc.identifier.epage176en_US
dc.identifier.isiWOS:A1988L392600024-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLee, SP=7601417497en_US
dc.identifier.scopusauthoridMaher, K=16171888900en_US
dc.identifier.scopusauthoridNicholls, JF=7201464908en_US

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