Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding: DISCUSSION (Part 5)
Gastric banding restricts food intake and hence leads to weight loss. Factors such as meal frequency, total calories consumed and calories as fat all influence gallbladder emptying through the release of CCK. This in turn affects the enterohepatic cycling of bile salts and hence, biliary lipid composition. The standard dose of CCK-8 given to quantitated gallbladder empting in the present study provides a consistent stimulus, but would not necessarily reflect day-to-day changes in the food ingested.
Likely the greatly reduced food intake in the first six weeks after surgery would have produced an even further decrease in gallbladder emptying. The apparent adaptation six months later presumably resulted from an improved dietary intake with more effective stimulation of the gallbladder, a decline in the rate of weight loss with less mobilization of cholesterol into bile and a relative improvement in cholesterol saturation. Indeed, the impaired gallbladder contractility evident in patients with cholesterol gallstones reflects the incorporation of this excess cholesterol into the plasma membranes of the gallbladder smooth muscle, altering their structure and function, and causing a defect in receptor-G protein coupling. During the severe weight loss six weeks after surgery, the greatly increased biliary cholesterol saturation would likely impair gallbladder motility to a greater extent than the lesser weight loss at six months. The present study was not designed to measure all these features. Buy drugs with confidence – buy levitra professional online to see how cheap your treatment can be.