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Article: Biliary sludge is formed by modification of hepatic bile by the gallbladder mucosa

TitleBiliary sludge is formed by modification of hepatic bile by the gallbladder mucosa
Authors
KeywordsChemicals And Cas Registry Numbers
Issue Date2005
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/cgh
Citation
Clinical Gastroenterology And Hepatology, 2005, v. 3 n. 7, p. 672-678 How to Cite?
AbstractBackground & Aims: We studied 22 patients with symptomatic microlithiasis to determine whether a contributory role of the gallbladder in the early stage of cholesterol gallstone formation exists. We compared the merits of different methods (ultrasonography and microscopy) and sources (hepatic or gallbladder) of bile samples for diagnosing microlithiasis. Methods: Paired hepatic and gallbladder bile samples were studied with polarizing microscopy. Nucleation time, bile salts, phospholipid, cholesterol, cholesterol saturation index (CSI), bilirubin, total protein, albumin and mucin concentration were measured. All patients had abdominal ultrasound examination. Results: With polarizing microscopy as the standard, ultrasonography was positive in 13 patients (59%) and negative in 9 (41%). All gallbladder bile samples were positive for microlithiasis by microscopy. Only one hepatic bile sample was positive (P < .0001). There was a disproportional enrichment of total protein, albumin, and mucin (P < .05) in the gallbladder bile and a conversion of bilirubin diglucuronide to monoglucuronide (P < .01). Gallbladder samples had lower CSI but a faster nucleation time (P < .001), which correlates inversely with CSI, total protein, and mucin concentration. Conclusion: Biochemical composition and physical chemical behavior of hepatic bile are modified during residence in the gallbladder, contributing to sludge formation. Gallbladder bile has a lower calculated CSI, higher deconjugation of bilirubin, protein and mucin concentration and crystals were present. Hepatic bile samples are inappropriate for microscopic detection of microlithiasis. © 2005 by the American Gastroenterological Association.
Persistent Identifierhttp://hdl.handle.net/10722/92513
ISSN
2015 Impact Factor: 7.68
2015 SCImago Journal Rankings: 2.744
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKo, CWen_HK
dc.contributor.authorSchulte, SJen_HK
dc.contributor.authorLee, SPen_HK
dc.date.accessioned2010-09-17T10:48:31Z-
dc.date.available2010-09-17T10:48:31Z-
dc.date.issued2005en_HK
dc.identifier.citationClinical Gastroenterology And Hepatology, 2005, v. 3 n. 7, p. 672-678en_HK
dc.identifier.issn1542-3565en_HK
dc.identifier.urihttp://hdl.handle.net/10722/92513-
dc.description.abstractBackground & Aims: We studied 22 patients with symptomatic microlithiasis to determine whether a contributory role of the gallbladder in the early stage of cholesterol gallstone formation exists. We compared the merits of different methods (ultrasonography and microscopy) and sources (hepatic or gallbladder) of bile samples for diagnosing microlithiasis. Methods: Paired hepatic and gallbladder bile samples were studied with polarizing microscopy. Nucleation time, bile salts, phospholipid, cholesterol, cholesterol saturation index (CSI), bilirubin, total protein, albumin and mucin concentration were measured. All patients had abdominal ultrasound examination. Results: With polarizing microscopy as the standard, ultrasonography was positive in 13 patients (59%) and negative in 9 (41%). All gallbladder bile samples were positive for microlithiasis by microscopy. Only one hepatic bile sample was positive (P < .0001). There was a disproportional enrichment of total protein, albumin, and mucin (P < .05) in the gallbladder bile and a conversion of bilirubin diglucuronide to monoglucuronide (P < .01). Gallbladder samples had lower CSI but a faster nucleation time (P < .001), which correlates inversely with CSI, total protein, and mucin concentration. Conclusion: Biochemical composition and physical chemical behavior of hepatic bile are modified during residence in the gallbladder, contributing to sludge formation. Gallbladder bile has a lower calculated CSI, higher deconjugation of bilirubin, protein and mucin concentration and crystals were present. Hepatic bile samples are inappropriate for microscopic detection of microlithiasis. © 2005 by the American Gastroenterological Association.en_HK
dc.languageengen_HK
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/cghen_HK
dc.relation.ispartofClinical Gastroenterology and Hepatologyen_HK
dc.subjectChemicals And Cas Registry Numbersen_HK
dc.titleBiliary sludge is formed by modification of hepatic bile by the gallbladder mucosaen_HK
dc.typeArticleen_HK
dc.identifier.emailLee, SP: sumlee@hku.hken_HK
dc.identifier.authorityLee, SP=rp01351en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S1542-3565(05)00369-1en_HK
dc.identifier.pmid16206500-
dc.identifier.scopuseid_2-s2.0-22144460102en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-22144460102&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume3en_HK
dc.identifier.issue7en_HK
dc.identifier.spage672en_HK
dc.identifier.epage678en_HK
dc.identifier.isiWOS:000234105600012-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridKo, CW=7202596492en_HK
dc.identifier.scopusauthoridSchulte, SJ=7006502482en_HK
dc.identifier.scopusauthoridLee, SP=7601417497en_HK

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