van der Linden W, Katzenstein B, Nakayama F
Cancer. 1983 Oct 1;52(7):1265-8. doi: 10.1002/1097-0142(19831001)52:7<1265::aid-cncr2820520722>3.0.co;2-8.
In consecutive patients with gallstones in well-functioning gallbladders, duodenal bile was sampled before and 2 to 3 months after cholecystectomy. The preoperative and postoperative bile acid patterns were compared. Cholecystectomy resulted in a significant shift from cholic- to chenodeoxycholic acid. This shift could help to explain the low incidence of recurrent common duct stones. The percentage of secondary bile acids showed very little change. An increase of the mean preoperative value of 3.9 percentage points or more was improbable (P = 0.025). This finding refutes the hypothesis that cholecystectomy could lead to colonic cancer via an increase in the proportion of secondary bile acids. An alternative hypothesis is proposed for the reported high incidence of previous cholecystectomy in colonic cancer. Both gallstones and cancer of the colon may be associated with high levels of secondary bile acids.
在胆囊功能良好且患有胆结石的连续患者中，于胆囊切除术前及术后2至3个月采集十二指肠胆汁样本。比较术前和术后的胆汁酸模式。胆囊切除术导致胆汁酸从胆酸向鹅去氧胆酸显著转变。这种转变有助于解释胆总管结石复发率低的原因。次级胆汁酸的百分比变化极小。术前平均值增加3.9个百分点或更多的可能性不大（P = 0.025）。这一发现驳斥了胆囊切除术可能通过增加次级胆汁酸比例导致结肠癌的假说。针对所报道的结肠癌患者中既往胆囊切除术的高发生率，提出了另一种假说。胆结石和结肠癌都可能与高水平的次级胆汁酸有关。
