DIFFERENCES IN GALLBLADDER BILE LITHOGENICITY IN PATIENTS AFTER GASTRECTOMY AND COLECTOMY

The differences in lithogenicity of gallbladder bile, biliary lipid co mposition, cholesterol saturation index (CSI), cholesterol nucleation time (NT), bilirubin, and ionized calcium were compared in patients wh o had previously undergone gastrectomy or colectomy. The increased CSI and the rapid NT were absent in gastrectomized patients, while colect omy significantly increased the CSI and accelerated the NT. The levels of ionized calcium and unconjugated bilirubin, possibly responsible f or pigment stone formation, were significantly higher in patients afte r gastrectomy, but were nearly absent in patients after colectomy. The results suggest that after gastrectomy the gallbladder bile indicates a trend towards pigment stone formation, whereas there is a trend tow ards cholesterol gallstones after colectomy. The different alterations of the gallbladder bile lithogenicity are clinically important.