A Model for Gallbladder Function and Cholesterol Gallstone Formation

An analysis of fluid mechanics and diffusion in the gallbladder predicts that there is a thin layer of high bile-constituent concentration near the gallbladder wall. Cholesterol may precipitate in this layer, even when the average cholesterol concentration in the gallbladder is below saturation. The...

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Bibliographic Details
Published in:Proceedings of the National Academy of Sciences - PNAS 1970-09, Vol.67 (1), p.400-407
Main Authors: Cussler, E. L., Evans, D. Fennell, DePalma, Ralph G.
Format: Article
Language:English
Subjects:
Bile
Bile acids
Bile Acids and Salts
Biological Sciences: Biochemistry
Chemical Precipitation
Cholelithiasis - physiopathology
Cholesterol
Cholesterols
Diffusion
Flow velocity
Gallbladder
Gallbladder - physiology
Gallbladder - physiopathology
Gallstones
Humans
Mathematics
Models, Biological
Phosphatidylcholines
Solutes
Solvents
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Summary:An analysis of fluid mechanics and diffusion in the gallbladder predicts that there is a thin layer of high bile-constituent concentration near the gallbladder wall. Cholesterol may precipitate in this layer, even when the average cholesterol concentration in the gallbladder is below saturation. The amount precipitated increases with time, with increased average cholesterol concentration, and with decreased average lecithin concentration. If the gallbladder does not empty completely, the precipitated cholesterol particles may grow over many cycles of gall bladder filling and emptying. The analysis explains why cholesterol-gallstone formation is not correlated with bile-constituent concentration alone, why a flaccid, noncontractile, gallbladder has a greater chance of forming gallstones, why small stones are frequently found near the gallbladder wall, and why stones may be found in only one limb of a double gallbladder.
ISSN:0027-8424
1091-6490
DOI:10.1073/pnas.67.1.400