Objective To probe into disorder of plasma lipids and apolipoproteins in patients with gallstone,and their position and function in formation of gallstone. MethodsConcentration of plasma lipids and apolipoproteins in 94 healthy subjects and 161 patients with gallstones was investigated. ResultsThe gallstone group had a higher serum mean concentration of TG,Apo CⅡ,Apo CⅢ, and had a lower serum mean concentration of TC，HDLc，HDL2c，HDL3c and LDLc as compared with the control group (P＜0.01 or P＜0.05). Conclusion Higher serum mean concentration of TG，Apo CⅡ，Apo CⅢ, and lower serum mean concentration of TC, HDLc, HDL2c, HDL3c and LDLc, are characteristic of lipids metabolism and important cause of formation of gallstone.
In 100 patients with gallstone, blood glucose, insulin were measured and BT-PAMA test, amino acid consumption test were made. Result: 71 patients were found with symptoms of the gut disorders, 12 cases with hyperglycemia (among them, 6 cases had chronic hepatic disease), 14 with exocrine pancreatic insufficiency, 26 with induration of the head of pancrease. The authors consider that hyper glycemia is correlated with chronic hepatic disease and that the gallstone migration impaires the pancreatic structure and function might be one of the factors which induces the symptom of gut disorders in patients with gallstone.
The authors invrstigated whenther samll dose of ursodeoxycholic acif treatment influences biliary concentration, nucleation time and gallbladder empting. 3 patients with cholesferd gallstones receired 400 mg ursodeoxychilic acid per prior to cholecystectomy. Treatment with small dose of ursodeoxycholic acid decreased the gallbladder chlesterol saturation index and prolonged the nucleation time ,bur had no effect on gallbladder empyting. We bilieve that snall dose of ursodeoxyxholic acis mat prevent the gallstone formation by decreasing xholecterol saturation index and lengthening the nucleation time.
Objective To study the relation between the pathogenesis of gallstone and blood lipid and protein.Methods Then indexes of blood lipid and protein in 204 cases of gallstone patients were measured and analysed by statistical software SPSS. Results There was a significant difference between the gallstone group and control in the value of proalbumin, total cholesterol, high density lipoprotein and carrier protein B (Ｐ＜0.01), the value of total protein, triglyceride, low density lipoprotein cholesterol, very low density lipoprotein cholesterol and carrier protein A1 were higher than those in the control (Ｐ＜0.05). Conclusion The indexes mentioned above may play an important role in the gallstone formation.
Eighty two cases of acute gallstone pancreatitis on early operation are reported and the significance of the clinical picture and pathology are analysed. The data showed that gallstone was found in 85.5%, among the cases of them mulliple gallstone was 71.1%, dilated cystic duct was 26.4%, common bile duct stone 36.8%, distal bile ductal stricture was found in 9.3%, and anomalous conjunction of biliary and pancreatic duct was 20.1%. Sixteen cases with serious pancreatitis were determined on operation, but death rate was 3.7% only. The authors claim that early operation may be of value in patients of acute gallstone pancreatitis with or without jaundice espesially in bile duct obstruction.
To study the mechanism of cholesterol gallstone formation, rabbit models were induced by feeding with high cholesterol diet. Bile acids were tested with bi-wavelengh thin layer scan and low density lipoprotein receptor activity of hepatocytes binding to 125I-LDL were tested with radio immunoassay in different feeding phases as 1,2,3 and 4-week groups, as well as the control group. The results showed that cholesterol gallstones in 2,3 and 4-week groups were induced in respectively. The contents of glucocholic acid (GCA) in bile were decreased significantly (vs control group, Ｐ＜0.05). The Bmax values of LDL receptor of hepatocytes binding to 125I-LDL were decreased significantly (Ｐ＜0.05). Kd values of those gradually increased (Ｐ＜0.05). These suggest that the decreased activity of LDL receptor of hepatocytes would reduce the synthesis of GCA, thus resulting in the formation of cholesterol gallstones.
To investigate the origin and releasing relation of motilin (MTL), vasoactive intestinal peptide (VIP) and somatostatin (SS) in guinea pig bile as well as its effects during gallstone formation. Guinea pig were divided into three groups: control group (50 animals), on normal diet; lithogenic group (70 animals), fed with lowprotein low fat; and recovering group (50 animals), fed with lowprotein low fat and recovering normal food after the experiment of gallstone formation. MTL, VIP and SS in the bile gallbladder tissue and portal vein plasma of the normal control group were measured with radioimmunoassay. Meanwhile the changes of the gut peptides in the bile and the bile components from different groups were also compared. Results: In control group the levels of MTL, VIP and SS in the bile were higher than those in the plasma, but, obviously lower than those in the tissues, the concentration relationship between in the bile and in the tissue was a positive correlation. In contrast to the control group, MTL concentration decreased but VIP and SS increased in the bile of the lithogenic group, the physicochemical nature of the bile also became lithogenic. In the recovering group the bile also became lithogenic, but, the concentration of those peptides and the nature of the bile all got normal. Conclusion: MTL, VIP and SS in guinea pig bile originate mainly form the gallbladder wall tissues. Food components affect the levels of the gut peptides in bile, which promote the bile lithogenic changes and gallstone formation.
Objective To evaluate the clinical effectiveness of ERCP/S+LC and LC+LCBDE in cholecystolithiasis and choledocholithiasis. Methods A fully recursive literature search was conducted in MEDLINE, EMbase, Cochrane Central Register of Controlled Trials in any language. By using a defined search strategy, both the randomized controlled trials (RCTs) and controlled clinical trials on comparing ERCP/ S+LC with LC+LCBDE in cholecystolithiasis and choledocholithiasis were identified. Data were extracted and evaluated by two reviewers independently. The quality of the included trials was evaluated. Meta-analyses were conducted using the Cochrane Collaboration’s RevMan 5.0.2 software. Results Fourteen controlled clinical trials (1 544 patients) were included. The results of meta-analyses showed that: a) There were no significant difference in the stone clearance rate between the two groups (RR=0.96, 95%CI 0.92 to 1.01, P=0.14); b) There were no significant difference in the residual stone rate between the two groups (OR=1.05, 95%CI 0.65 to 1.72, P=0.83); c) There were no significant difference in the complications morbidity between the two groups (OR=1.12, 95%CI 0.85 to 1.55, P=0.48); d) There were no significant difference in the mortality during follow-up visit between the two groups (RD= 0.00, 95%CI –0.03 to 0.03, P=0.84); e) The length of hospital stay in the LC+LCBDE group was shorter than that of the ERCP/S+LC group with significant difference (WMD= 1.78, 95%CI 0.94 to 2.62, Plt;0.000 1); and f) The LC+LCBDE group was superior to the ERCP/S+LC group in the aspects of procedure time and total hospital charges. Conclusion Although there aren’t differences in the effectiveness and safety between the ERCP/S+LC group and the LC+LCBDE group, the latter is superior to the former in procedure time, length of hospital stay and total hospital charges. For the influencing factors of lower quality and astable statistical outcomes of the included studies, this conclusion has to be verified with more strictly designed large scale RCTs.
Serum concentration of follicularstimulating hormone(FSH),lutenizing hormone(LH),prolactin（PRL），estradio(E2),erstriol(E3) and progesterong(P) of 56 women with gallstones and 53 other female patients were measured by radioimmunoassqy.It was found that the levels of serum estrogen were not only in reproductive aged or postmenopausal women, but also in women with or without gallstones. So it is not certain of the relation between estrogen and gallstone from this study.
Objective To discuss the relationship between motilin, vasoactive intestinal peptide and the gallstone formation. Methods The level of motilin, vasoactive intestinal peptide in plasma, bile and gallbladder tissue of 48 cases of chololithiasis before operation and the first, third, seventh day after cholecystectomy were mesured by radioimmunoassay. Results The level of motilin in plasma was markedly increased in patients with chololithiasis before cholecystectomy and the first day after cholecystectomy. The level of motilin, vasoactive intestinal peptide in bile and gallbladder tissue were significantly increased in patients and motilin was positively correlated with vasoactive intestinal peptide in the gallbladder tissue. Conclusion Motilin, vasoactive intestinal peptide might affect the gallstone formation by affecting the motility of gallbladder.