Abstract
The rôle of the biliary system in the metabolism of cholesterol is not well understood. Cholesterol taken in the food is largely absorbed into the blood. Some is excreted into the bile, but is to a large extent reabsorbed. The cholesterol in the faeces should theoretically be derived partly from the food, partly from the bile. Dorée and his associates concluded that the cholesterol in the faeces could be accounted for entirely by the cholesterol of the food. That cholesterol can be and is absorbed in the intestinal tract has been repeatedly demonstrated. That cholesterol can be absorbed by the gallbladder is believed by many, but has not been conclusively demonstrated.
Many experimenters 1 , 2 , 3 , 4 have injected cholesterol and other lipoids into the gallbladder and after ligating the cystic duct have noted a degree of absorption. Boyd 5 was able to demonstrate a lowering of the blood cholesterol 9 days after cholecystectomy. Sweet, 6 however, found a rise in blood cholesterol of almost double normal after cholecystectomy, which continued to be present for about 40 days and became lower than normal only after 72 days.
It would appear logical that if bile were lost by the presence of a biliary fistula there should be a definite reduction in blood cholesterol. If cholesterol is absorbed in the gallbladder this reduction should be even more marked if a complete biliary fistula were made and the gallbladder removed also.
Attempt was made to demonstrate the changes in the blood cholesterol in dogs with a complete biliary fistula, both with and without the presence of the gallbladder. All the animals were fed a special kennel food in amounts calculated according to their body weights. Repeated daily readings of the blood cholesterol were made.
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