Effect of wheat bran on serum lipoproteins and biliary lipids.

In this study nine patients with gallstones and nine healthy volunteers were given a high bran diet for 4 weeks. At the outset and at 4 weeks bile specimens were obtained for determination of biliary lipid values, size of the bile-acid pool and bile-acid ratios, and blood specimens were drawn to determine the serum concentration of triglycerides and of lipoprotein-bound cholesterol. Three patients with gallstones remained on the high bran diet for 6 months or more and samples were analysed again. The high bran diet produced a substantial decrease in biliary cholesterol values in patients with gallstones after 4 weeks, and a significant increase in the concentration of high density lipoprotein-cholesterol in the serum of patients who course was followed for 6 months or longer.

The effect of prosthetic gallstones on total bile acid pool size in dogs.

A reduction in total bile acid pool size was noted in nine of ten dogs after the implantation of inert prosthetic gallstones. Sham cholecystotomy without implantation of a prosthesis also produced a small decrease in bile acid pool size but was significantly less than the decrease noted with prosthetic stones. Bile acid ratios--cholic acid, chenodeoxycholic acid and deoxycholic acid--did not change after implantation of prosthetic stones. These findings raise the possibility that the small total bile acid pool size noted in patients with cholesterol gallstones is a phenomenon secondary to the pathologic state of the gallbladder.

The effect of hepatic bile on retained common duct stones.

Study of the time interval since cholecystectomy in 91 patients with symptomatic choledocholithiasis who presented after cholecystectomy led to the conclusion that retained common duct stones increase in size with the passage of time. The inference is that, in these patients bile remains supersaturated with cholesterol after cholecystectomy.

Prolonged secretion of lithogenic bile after cholecystectomy.

Hepatic bile samples were obtained from 8 subjects 1 1/2 to 23 years after cholecystectomy for presumed cholesterol gallstones. The content of cholesterol, bile acids and lecithin was determined for each bile sample and compared to the values found in gallbladder bile in 15 control subjects undergoing cholecystectomy for pure and mixed cholesterol stones. Plot of the data on triangular coordinates and subsequent determination of lithogenic index showed that bile was supersaturated with cholesterol in both groups of patients. The cholesterol content of bile remained at supersaturated levels following cholecystectomy and showed no tendency to return toward normal levels with the passage of time.