Causes of biliary sludge


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Abstract

Aim. To specify characteristics of biochemical bile composition contributing to destabilization of colloid properties of bile in patients with biliary "sludge".
Material and methods. 37patients with "sludge" in the gallbladder (GB), 10 patients with cholelithiasis and 10 patients with intact GB participating in the study were examined for bile portion В bile acids (BA), cholesterol and phospholipids (PL); lipid and lipoprotein blood composition. Results. Three types of biochemical composition of bile in GB "sludge" patients were identified. 22 patients had elevated levels of cholesterol and PL in subnormal content of BA (group I); 9 patients had normal FA and cholesterol, low content of biliary PL (group 2); 6 patients had normal concentrations of the three components (group 3). Blood lipids were characterized by elevated levels of total cholesterol and LDLP cholesterol in group I; low HDLP cholesterol and triglycerides in group 2 and almost normal values in group 3. Basing on these data, causes of "sludge"formation in the GB are suggested. Conclusion. Biliary "sludge" may form because of excessive cholesterol in bile, low phospholipid levels or in normal proportion of the studied substances.

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