The experimental production of gall-stones in dogs,in the absence of infection,stasis,and gall bladder influence upon the bile

Abstract

Numerous circumstances and influences which favor the development of gall-stones are now recognized, but uncertainty exists as to which of them are contributory in character and which critical, and as to whether indeed the decisive causes for cholelithiasis are to be found amongst them. In this connection, observations under controlled conditions in animals possess interest.

By a method elsewhere reported, 1 it is possible to join a rubber tube to the common duct of a dog and collect the bile under sterile conditions for months. The gall bladder should be removed at the time of intubation. Our animals thus treated remained in excellent condition, but the observations on several of them were cut short by calculus formation in the collecting system. Twelve dogs have been studied with relation to this development. Calculi were found in six, and in three of these the bile had been sterile. In two of the three instances, the calculi gradually filled the 2 mm. lumen of a glass canula on the wall of which they were sessile, and gave rise to obstruction. Once this happened within twenty-one days of intubation.

The calculi were found only on the walls of the collecting system of rubber and glass, never in the ducts themselves; and they occurred in none of five instances in which this system remained clear of organic débris (dead cells and mucinous matter), but in six out of seven in which there was lodgment of such material,—from which the ducts were always practically free. The stones were multiple, discrete,—at least to begin with,—of approximately the same size at any given level in the tube system, but larger toward the glass canula inserted into the common duct, and more numerous and larger on the lower side of the tube lumen and wherever there existed the possibility for an eddy in the bile current or a dead space, as where glass and rubber joined. The calculi that had formed on the glass connections could be examined directly with the microscope. Early stages were studied in this way.