Pitt H A, Doty J E, DenBesten L, Kuchenbecker S L
Am J Surg. 1982 Jan;143(1):144-9. doi: 10.1016/0002-9610(82)90145-3.
Gallbladder stasis occurs before gallstone formation and provides the link between the hepatic secretion of supersaturated bile and cholesterol cholelithiasis. We recently observed that cystic duct resistance increases while sphincter of Oddi resistance is unchanged in the presence of lithogenic bile without gallstones. Whether alterations in gallbladder function also lead to gallbladder stasis has been unclear. Therefore, we tested the hypothesis that before gallstone formation, stasis results from increased cystic duct resistance and altered gallbladder compliance. Adult, male prairie dogs were fed either a trace cholesterol (control) or a 0.4 percent cholesterol-enriched diet. Cystic duct resistance increased but gallbladder compliance was unchanged before gallstone formation. A significant correlation (p less than 0.001) was found between the lithogenic index and cystic duct resistance in pregallstone animals. We conclude that increased resistance to flow across the cystic duct, and not altered gallbladder compliance, is etiologically related to bile stasis, an important event in gallstone formation.
胆囊淤滞在胆结石形成之前就已出现，它是肝脏分泌的过饱和胆汁与胆固醇性胆结石之间的联系。我们最近观察到，在存在致石性胆汁但无胆结石的情况下，胆囊管阻力增加，而Oddi括约肌阻力未变。胆囊功能的改变是否也会导致胆囊淤滞尚不清楚。因此，我们检验了这样一个假设，即在胆结石形成之前，淤滞是由胆囊管阻力增加和胆囊顺应性改变所致。成年雄性草原犬鼠分别喂食微量胆固醇（对照）或富含0.4%胆固醇的饮食。在胆结石形成之前，胆囊管阻力增加，但胆囊顺应性未变。在结石形成前的动物中，致石指数与胆囊管阻力之间存在显著相关性（p<0.001）。我们得出结论，跨胆囊管的流动阻力增加而非胆囊顺应性改变，在病因上与胆汁淤滞相关，胆汁淤滞是胆结石形成中的一个重要事件。
