Bile Composition in Healthy and Gallstones Patients
Bile Composition in Healthy and Gallstones Patients
Determine differences between lithogenic and non-lithogenic bile composition.
Gallstones constitute an entity known from antiquity, which have been found even in Egyptian
 mummies. In elder Greece, Tralliano discovered that gallstones are formed in the liver.
 Vesalio and Falopio described gallstones inside de gallbladder after a human body dissection
 and in 1882 Langenbuch performed the first cholecystectomy with good results, becoming the
 gold standard technique for cholelithiasis.

 Nowadays, this pathology represents a public health problem in developed countries due to its
 high prevalence, which is getting higher, estimated between a 10 and a 15% of the population.

 However, gallstones are asymptomatic in the 80% of the cases. In 5 years, a 10-20% of these
 patients will become symptomatic. The global risk of generating symptoms is about a 2% per
 year, meanwhile biliary tract complications in asymptomatic patients represent a 0'3% per
 year.

 There are two main types of gallstones. The most common of them (70%) are cholesterol stones,
 composed of >50% of cholesterol. The other 30% are black pigment stones, with less than 20%
 of cholesterol in their composition.

 The common ways on gallstone formation are: cholesterol supersaturation (due to a liver
 oversecretion); defects on gallbladder absorption, secretion and motility mechanisms; and
 higher percentage of deoxycholic acid in the biliary acids due to a slower intestinal
 movement. All of that leads to supersaturation and cholesterol nucleation.

 Black pigment stones are formed of calcium bilirrubinate. The formation mechanism is not
 clearly defined, but there is an increment in not conjugated bilirubin levels, which is less
 soluble in water. These gallstones are more frequent in patients who show higher levels of
 this bilirubin, such as those with hemolysis, Gilbert syndrome or hereditary spherocytosis.
 They are also common in patients with Crohn disease (specially in those with ileal resection)
 and cystic fibrosis, in which exists an enterohepatic circulation alteration, driving to an
 increase on biliary salts and non-conjugated bilirubin levels.

 Our work hypothesis is that bile composition in patients with gallstones on the gallbladder
 is different from those who doesn't show lithiasis.
Inclusion Criteria for the Study Group:

 1. Patients included for an elective cholecystectomy.

 2. Normal hepatic and renal function.

 3. Able to understand the nature of the study.

 4. Wish to participate in the study and sign the informed consent.

 Inclusion Criteria for the Control Group:

 1. Patients included for an hepatectomy with gallbladder exeresis for surgery reasons,
 without lithiasis.

 2. Patients included for peritoneal carcinomatosis surgery with gallbladder exeresis for
 surgery reasons, without lithiasis.

 3. Organ donors.

 4. Normal hepatic and renal function.

 5. Able to understand the nature of the study.

 6. Wish to participate in the study and sign the informed consent.

 Exclusion Criteria:

 1. Under 16 years old

 2. Hepatic or renal insufficiency

 3. Impossibility to understand the aim of the study