12 Jul

Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding (Part 1)

GallstonesGallstones are common. The prevalence in developed countries ranges between 6% and 16% in adults, and is especially high in women during their reproductive years. This frequency increases to 30% in morbidly obese women. Although treatment for mild obesity is mainly dietary, major surgery plays a role in those who are morbidly obese. Both dieting and surgery, however, are associated with a heightened risk of developing gallstones.

Those losing considerable weight are at an even greater risk of stone formation, when compared with similarly obese persons on a weight maintenance diet. Rapid weight loss generates an 18-fold increase in gallstone development, whereas less rapid weight loss appears relatively safe. Weight loss of up to 1.5 kg per week, or up to 1% to 1.5% of the total body weight per week is not associated with any increase in stone formation.

The livers of obese patients secrete abnormal bile, containing an excess of cholesterol relative to its solubilizing capacity. In the presence of a nucleating factor, the excess cholesterol then precipitates from this supersaturated bile. Gallbladder stasis also contributes to cholesterol gallstone formation, allowing the time necessary for the microcrystals of cholesterol to precipitate, be retained, aggregate and subsequently grow into macroscopic stones. After an overnight fast, obese people have larger gallbladder volumes compared with those of normal sized individuals. Body mass index (BMI), however, is not the sole determinant of gallstone formation. Large people in general, regardless of their BMI, also have large fasting gallbladder volumes, but do not necessarily develop gallstones, perhaps because of a more normal cholesterol solubility of bile. Find out more about your chance to visit the most trusted pharmacy you could ever find to get cialis professional canadian pharmacy in the amounts required, without any need to see your health care provider first or get a prescription.

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