Increase in Cholesterol Content of Gallbladder Bile Following Ligature of Cystic Duct.

Abstract

The action of the gallbladder wall on the cholesterol content of the bile within its lumen has long been the subject of much dispute. To study this problem experimentally a number of different procedures were carried out. One of these consisted in ligating the cystic duct, aspirating a sample of the gallbladder contents and comparing its composition with that obtained several days afterwards. As such a puncture tends to leak it is necessary to tie a ligature around it, which usually causes a more or less severe inflammatory reaction. To obviate the effects of the ligature on the wall of the organ, at the suggestion of Dr. W. H. Cole, gallbladder contents were obtained by puncturing the posterior wall of the viscus, introducing the needle through the liver parenchyma, thus doing away with the necessity of tying a ligature. In some experiments we incised the cystic duct, aspirated through this opening and ligated on either side. In other experiments only a few cc. were removed and the correction due to change in volume by concentration (through absorption of water) or dilution (through the secretion of mucus) taken into account by measuring the bilirubin of the bile each time. In only one case out of seven was there evidence of absorption of cholesterol by the gallbladder. In this experiment there was an increase in the cholesterol concentration of 93% during 2 days but since the bilirubin concentration increased 107% it is obvious that a small amount of cholesterol had disappeared and presumably had been absorbed. This difference is slight and may even be within the range of experimental error. In the other 6 experiments there was a much more marked increase in cholesterol concentration than in the bilirubin.