Cholelithiasis and bile acid absorption after truncal vagotomy and gastroenterostomy

Author:

Thompson D1,Wild R1,Merrick M V1,Brydon G1,MacIntyre I M C1,Eastwood M A1

Affiliation:

1. Gastrointestinal Unit, Western General Hospital, Edinburgh, UK

Abstract

Abstract Gallbladder disease in the form of gallstones demonstrated by ultrasonography or previous cholecystectomy was found in 15 of 26 women of median age 69 (range 52–82) years who had had truncal vagotomy and gastroenterostomy performed a median of 27 (range 11–30) years previously, compared with eight of 31 healthy age-and sex-matched controls drawn from the community (P < 0·02). Bile acid malabsorption identified by retention of 23-selena, 25-homotaurocholate (75SeHCAT) occurred in only two of the 26 patients after vagotomy and there was no relationship between retention and the presence or absence of gallbladder disease. The serum concentration of 7 α-hydroxycholestenone, an indicator of bile acid turnover, was significantly lower in patients with gallbladder disease after vagotomy than in controls (mean(s.e.m.) 19·1(3·7) versus 31·4(4·4) ng/ml, P < 0·05). Bile acid malabsorption does not play a significant role in the pathogenesis of gallstones after vagotomy but decreased bile acid synthesis may be important. There is no correlation between retention of 75SeHCAT and 7 α-hydroxycholestenone levels in patients after vagotomy, indicating that bile acid synthesis and absorption are uncoupled in this situation.

Publisher

Oxford University Press (OUP)

Subject

Surgery

Cited by 6 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Clinical Significance of Biliary Dilatation and Cholelithiasis after Subtotal Gastrectomy;The Korean Journal of Gastroenterology;2015

2. Bile Acid Malabsorption;Textbook of Clinical Gastroenterology and Hepatology;2012-04-16

3. Indications and results for transduodenal sphincteroplasty in the era of endoscopic sphincterotomy;The American Journal of Surgery;2010-08

4. Increased risk of cholelithiasis after esophagectomy;Journal of Hepato-Biliary-Pancreatic Surgery;2004-10

5. Serum 7α-hydroxy-4-cholesten-3-one and selenohomocholyltaurine (SeHCAT) whole body retention in the assessment of bile acid induced diarrhoea;European Journal of Gastroenterology & Hepatology;1996-02

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