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Portincasa P, van Erpecum KJ, Di Ciaula A, et al. The physical presence of gallstone modulates . Gastroenterol Rep (Oxf). 2018;7(1):32-41doi: 10.1093/gastro/goy044.
Portincasa, P., van Erpecum, K. J., Di Ciaula, A., & Wang, D. Q. (2019). The physical presence of gallstone modulates . Gastroenterology report, 7(1), 32-41. https://doi.org/10.1093/gastro/goy044
Portincasa, Piero, et al. "The physical presence of gallstone modulates ." Gastroenterology report vol. 7,1 (2019): 32-41. doi: https://doi.org/10.1093/gastro/goy044
Portincasa P, van Erpecum KJ, Di Ciaula A, Wang DQ. The physical presence of gallstone modulates . Gastroenterol Rep (Oxf). 2019 Feb;7(1):32-41. doi: 10.1093/gastro/goy044. Epub 2018 Dec 05. PMID: 30792864; PMCID: PMC6375352.
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Gastroenterol Rep (Oxf). 2019 Feb;7(1):32-41. doi: 10.1093/gastro/goy044. Epub 2018 Dec 05.

The physical presence of gallstone modulates .

Gastroenterology report

Piero Portincasa, Karel J van Erpecum, Agostino Di Ciaula, David Q-H Wang

Affiliations

  1. Division of Internal Medicine, Department of Biomedical Sciences and Human Oncology, University Medical School, Bari, Italy.
  2. Department of Gastroenterology, University Medical Center, Utrecht, The Netherlands.
  3. Division of Internal Medicine, Hospital of Bisceglie, ASL BAT, Bisceglie, Italy.
  4. Department of Medicine, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Albert Einstein College of Medicine, Bronx, NY, USA.

PMID: 30792864 PMCID: PMC6375352 DOI: 10.1093/gastro/goy044

Abstract

BACKGROUND: Cholesterol crystallization is an essential step toward gallstone formation. Although model bile studies showed that competition occurs between the gallstone surface and the surrounding aqueous phase for cholesterol molecules available for crystallization, this has not been investigated in human bile.

METHODS: Fresh gallbladder bile was obtained during laparoscopic cholecystectomy from 13 patients with cholesterol (

RESULTS: In unfiltered bile, the presence of stones was associated with a trend towards less anhydrous cholesterol crystals, but significantly more aggregated cholesterol monohydrate crystals. In ultrafiltered bile, the presence of stones tended to inhibit the formation of arc-like or needle-like crystals and was associated with significantly greater amounts of both plate-like and aggregated cholesterol monohydrate crystals. After 21 days of the incubation, stone weight was decreased in both unfiltered (-4.5 ± 1.6%,

CONCLUSIONS: The physical presence of cholesterol gallstones in both native and filtered bile greatly influences cholesterol crystallization pathways. Whereas cholesterol monohydrate crystals increase, anhydrous cholesterol crystals tend to be inhibited. Detachment of solid cholesterol crystals from the gallstone surface may explain these findings.

Keywords: Bile; cholesterol crystals; cholesterol stones; pigment stones; polarizing light microscopy; supersaturated bile

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