Gastroenterology
Volume 93, Issue 1 , Pages 98-105 , July 1987

Dissolution of cholesterol gallstones in vitro: Gallstone matrix content and diameter, not cholesterol content, predict gallstone dissolution in monooctanoin

  • Bernard F. Smith

      Affiliations

    • Corresponding Author InformationAddress requests for reprints to: Bernard F. Smith, M.D., Section of Gastroenterology, University Hospital, 75 East Newton Street, Boston, Massachusetts 02118.

Received 2 October 1986 ,Accepted 9 February 1987.

References 

  1. McSherry CK, Glenn F. The incidence and causes of death following surgery for non-malignant biliary tract disease. Ann Surg. 1980;191:271–279
  2. Shoenfield LJ, Lachin JM, the Steering Committee   the National Cooperative Gallstone Study Group. Chenodoil (chenodeoxycholic acid) for dissolution of gallstones. Ann Intern Med. 1981;95:257–282
  3. Tokyo Cooperative Gallstone Study Group. Efficacy and indications of ursodeoxycholic acid treatment for dissolving gallstones. A multicenter double blind trial. Gastroenterology. 1980;78:542–548
  4. Fromm H, Roat JW, Gonzalez V, Sarva RP, Farivar S. Comparative efficacy and side effects of ursodeoxycholic and chenodeoxycholic acids in dissolving gallstones. Gastroenterology. 1983;85:1257–1264
  5. Mazer NA, Schurtenberger P, Carey MC, Presig R, Weigand K, Kanzig W. Quasi-elastic light scattering studies of native hepatic bile from the dog: comparison with aggregative behavior of model biliary lipid systems. Biochemistry. 1984;23:1994–2005
  6. Kibe A, Dudley MA, Halpern Z, Lynn MP, Breurer AC, Holzbach RT. Factors affecting cholesterol monohydrate crystal nucleation time in model systems of supersaturated bile. J Lipid Res. 1985;26:1102–1111
  7. Levy PF, Smith BF, LaMont JT. Human gallbladder mucin accelerates nucleation of cholesterol in artificial bile. Gastroenterology. 1984;87:270–275
  8. Salvioli G, Igimi H, Carey MC. Cholesterol gallstone dissolution in bile. Dissolution kinetics of crystalline cholesterol monohydrate by conjugated chenodeoxycholate-lecithin and conjugated ursodeoxycholate-lecithin mixtures: dissimilar phase equilibria and dissolution mechanisms. J Lipid Res. 1983;24:701–720
  9. Corrigan OI, Su CC, Higuchi WI, Hofmann AF. Mesophase formation during cholesterol dissolution in ursodeoxycholate-lecithin solutions: new mechanism for gallstone dissolution in humans. J Pharm Sci. 1980;69:869–871
  10. Thistle JL, Carlson G, Hofmann AF, et al.  Monooctanoin, a dissolution agent for retained cholesterol bile duct stones: physical properties and clinical application. Gastroenterology. 1980;78:1016–1022
  11. Allen MJ, Borody TJ, Bugliosi TF, May GR, LaRusso NF, Thistle JL. Rapid dissolution of gallstones by methyl tertbutyl ether. N Engl J Med. 1985;312:217–220
  12. Allen MJ, Borody TJ, Thistle JL. In vitro dissolution of cholesterol gallstones. A study of factors influencing rate and a comparison of solvents. Gastroenterology. 1985;89:1097–1103
  13. Whiting MJ, Jarvinen V, Watts J McK. Chemical composition of gallstones resistant to dissolution therapy with chenodeoxycholic acid. Gut. 1980;21:1077–1081
  14. Freilich HS, Malet PF, Schwartz JS, Soloway RD. Chemical and morphologic characteristics of cholesterol gallstones that failed to dissolve on chenodiol. The National Cooperative Gallstone Study. Gastroenterology. 1986;91:713–718
  15. Womack N, Zeppa R, Irving G. The anatomy of gallstones. Surg Gynecol Obstet. 1963;132:846–851
  16. Smith BF, LaMont JT. Identification of gallbladder mucinbilirubin complex in human cholesterol gallstone matrix. Effects of reducing agents on in vitro dissolution of matrix and intact stones. J Clin Invest. 1985;76:439–445
  17. Allen B, Bernhoft R, Blanckaert N, et al.  Sludge is calcium bilirubinate associated with bile stasis. Am J Surg. 1981;141:51–56
  18. Lee SP, Nichols JF. Nature and composition of biliary sludge. Gastroenterology. 1986;90:677–686
  19. Smith BF, LaMont JT. Bovine gallbladder mucin binds bilirubin in vitro. Gastroenterology. 1983;85:707–712
  20. Smith BF, LaMont JT. Hydrophobic binding properties of bovine gallbladder mucin. J Biol Chem. 1984;259:12170–12177
  21. Sutor DJ, Wooley SE. The organic matrix of gallstones. Gut. 1974;15:487–491
  22. Been JM, Bills PM, Lewis DL. Microstructure of gallstones. Gastroenterology. 1979;76:548–555
  23. Bills PM, Lewis DL. A structural study of gallstones. Gut. 1975;16:630–637
  24. Leuschner U, Baumgatel H. Gallstone dissolution in the biliary tract: in vitro investigations of inhibiting factors and special dissolution agents. Am J Gastroenterol. 1982;77:222–226
  25. Bogardus JB. Unusual cholesterol solubility in water/glyceryl1-monooctanoate solutions. J Pharm Sci. 1982;71:370–372
  26. Small DM. The formation of gallstones. In: 3rd ed.  Stollerman G editors. Advances in internal medicine. 20:Chicago: Yearbook Medical Publishers; 1970;p. 243–264
  27. Trotman BW, Ostrow JD, Soloway RD. Pigment vs cholesterol cholelithiasis: comparison of stone and bile composition. Am J Dig Dis. 1974;19:585–590
  28. Park Y-H, Igimi H, Carey MC. The “mirroring” of gallstones: description of a novel silvering method to determine the surface area of an irregular object. In vitro demonstration that multiple gallstones from the same gallbladder dissolve in unsaturated “bile” at the same rate. Gastroenterology. 1982;83:1071–1078
  29. Mok YI, Druffel ERM, Rampone WM. Chronology of gallstones. Dating gallstones from atmospheric radiocarbon produced by nuclear bomb explosions. N Engl J Med. 1986;314:1075–1077

☆ This work was supported by a National Institutes of Health Clinical Investigator Award (AM 01328).

☆☆ This work was presented in part at the Annual Meeting of the American Gastroenterological Association in May 1986 in San Francisco, California, and published in abstract form in Gastroenterology 1986;90:1769.

PII: 0016-5085(87)90320-9

Gastroenterology
Volume 93, Issue 1 , Pages 98-105 , July 1987

Article Tools