Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding: DISCUSSION (Part 2)
The current study did not demonstrate any differences between the male and female volunteers in their gallbladder motility in terms of emptying, refilling or gallbladder volume. A sex difference in the incidence of gallstones exists between men and women, but this is not linked to any proposed difference in gallbladder motility caused by the female sex hormones. Men generally have greater fasting gallbladder volumes than women. It thus seemed reasonable to combine the sexes, because women predominated in these morbidly obese patients seeking bariatric surgery.
Gallbladder volume after an overnight fast and following a standard infusion of CCK-8 was different in the obese compared with that of the normal controls, as has been demonstrated previously. Increased gallbladder volume with poor mixing and a long residence time favours the development of biliary sludge and hence stone formation. Further, after an overnight fast, quite saturated bile from the liver is likely to enter a gallbladder with a large volume. Even after a meal has partially emptied the gallbladder, a relatively large residual volume of bile remains. Gallbladder filling is contingent on the rate of hepatic bile secretion, the relative resistance to entry through the cystic duct and within the gallbladder (intra-vesicular pressure), and the metering effect of sphincter of Oddi tone. The hepatic secretion rate, in turn, predominantly reflects the portal venous return of bile salts; this is presumably higher in obese people because they empty a larger absolute volume of gallbladder bile and have large bile salt pools. You can be sure this pharmacy will offer the finest quality drugs you need, so buying cialis super active online will always be safe and very pleasant for you as a customer and patient.