EVIDENCE OF IMPAIRED ACIDIFICATION IN-VITRO BY HUMAN GALL-BLADDER MUCOSA IN PATIENTS WITH GALLSTONE DISEASE

Objective: To study the capacity of the human gall bladder with and wi thout gallstones to secrete H+ ions. Design: Human gall bladders were studied in vitro which permitted the measurement of the electrical pot ential difference and secretion of H+ ions. Results: Thirty-three gall bladders were studied (five normal, 20 with cholesterol and eight wit h pigment gallstones). The normal gall bladder group secreted 14.53+/- 1.04 nmol (mean+/- SEM), the mildly inflamed group 8.27+/- 1.71 nmol and the moderately inflamed group 4.03+/- 0.94 H+ over 60 min in the m ucosal bathing fluid. H+ secretion was significantly different when th e mildly and moderately inflamed groups were compared with the normal group (P < 0.002 and P < 0.009, respectively). When the mildly (-6.14/- 0.36 nmol) and moderately (-2.54+/- 0.87 nmol) inflamed groups were compared with the normal group (-8.14+/- 0.93 nmol) over 60 min, ther e was a significant change in H+ secretion (P < 0.02 and P < 0.04, res pectively) in the serosal bathing fluid. The potential difference was 9.68+/- 0.45 mV in the normal group, 8.25+/- 0.53 mV in the mildly inf lamed group and 7.18+/- 0.67 mV in the moderately inflamed group. Ther e was no association between H+ secretion and age, sex, alcohol and ci garette consumption, or contraceptive use. Conclusions: H+ secretion i s abnormal in the gall bladders of patients with gallstone disease. Im pairment correlates with the severity of cholecystitis, probably contr ibuting to the formation of gallstones.