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Murray FE, Hawkey CJ. Therapeutic approaches to the problem of biliary sludge and gallstone formation during total parenteral nutrition. Clin Nutr. 1992;11(1):12-7doi: 10.1016/0261-5614(92)90057-w.
Murray, F. E., & Hawkey, C. J. (1992). Therapeutic approaches to the problem of biliary sludge and gallstone formation during total parenteral nutrition. Clinical nutrition (Edinburgh, Scotland), 11(1), 12-7. https://doi.org/10.1016/0261-5614(92)90057-w
Murray, F E, and Hawkey, C J. "Therapeutic approaches to the problem of biliary sludge and gallstone formation during total parenteral nutrition." Clinical nutrition (Edinburgh, Scotland) vol. 11,1 (1992): 12-7. doi: https://doi.org/10.1016/0261-5614(92)90057-w
Murray FE, Hawkey CJ. Therapeutic approaches to the problem of biliary sludge and gallstone formation during total parenteral nutrition. Clin Nutr. 1992 Feb;11(1):12-7. doi: 10.1016/0261-5614(92)90057-w. PMID: 16839963.
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Clin Nutr. 1992 Feb;11(1):12-7. doi: 10.1016/0261-5614(92)90057-w.

Therapeutic approaches to the problem of biliary sludge and gallstone formation during total parenteral nutrition.

Clinical nutrition (Edinburgh, Scotland)

F E Murray, C J Hawkey

Affiliations

  1. Department of Therapeutics, University Hospital, Nottingham, NG7 2UH, UK.

PMID: 16839963 DOI: 10.1016/0261-5614(92)90057-w

Abstract

Prolonged total parenteral nutrition is associated with the development of biliary sludge, which consists of super-saturated bile containing cholesterol crystals, bilirubin granules and a very high concentration of mucin glycoprotein. Reduced gallbladder contractility in TPN patients appears to be essential for the pathogenesis of sludge, which represents an important stage in the formation of gallstones, a common and well recognised complication of TPN. Possible approaches to the prevention of these biliary complications of TPN include: 1) inhibition of prostaglandin mediated mucin hypersecretion with aspirin, NSAIDs or possibly by n-3 essential fatty acids; 2) stimulation of gallbladder contractility by early oral feeding or the use of CCK; and 3) reduction of cholesterol saturation and mucin secretion by ursodeoxycholic acid.

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