Possible ways to prevent gallstone formation from lessons learnt on its pathogenesis / 中华肝胆外科杂志

ABSTRACT

Cholesterol gallstone disease is prevalent and its incidence is increasing in China. Supersaturation of biliary cholesterol is a prerequisite for gallstone formation.Recent studies show that disorders of hepatic-enteric metabolism of lipids play important roles in the pathogenesis of gallstone disease and these include： increased biliary cholesterol which originates from an increased uptake of plasma high density lipoprotein mediated by scavenger receptor B type 1,increased secretion of cholesterol into bile via hepatic canalicular cholesterol transporters, and increased intestinal cholesterol absorption in gallstone patients. These eventually lead to supersaturation of biliary cholesterol. Evidences also suggest that decreasing hepatic cholesterol loading, promoting biliary bile acids and phospholipids secretion, and/or inhibiting intestinal cholesterol absorption can moderate saturation of biliary cholesterol, and prevent gallstone formation.