EFFECTS OF BILE-SALT AND PHOSPHOLIPID HYDROPHOBICITY ON LITHOGENICITYOF HUMAN GALLBLADDER BILE

Increased biliary bile salt and phospholipid hydrophobicity may promot e nucleation of cholesterol crystals and gallstone formation. We there fore compared bile salt composition (determined by gas-liquid chromato graphy) in patients with cholesterol (n = 35) and pigment (n = 16) gal lstones (group A). Bile salt composition and cumulative bile salt hydr ophobicity index were not different between both stone types. Hydropho bicity index or % of individual bile salts did not correlate with chol esterol saturation index or nucleation time. In an additional 21 chole sterol stone patients (group B) biliary bile salt and phospholipid hyd rophobicity as determined by high-pressure liquid chromatography did n ot correlate with cholesterol saturation index or nucleation time, In both group A and group B, cholesterol stone patients with cholesterol crystals in their fresh biles had a higher % deoxycholic acid, a lower % cholic acid and a higher bile salt hydrophobicity index than crysta l-negative patients. This study indicates the need for further researc h on the role of bile salt hydrophobicity in the pathogenesis of galls tones.