ABSTRACT
Changes in gallbladder motility and alteration of bile composition have been implicated in the formation of gallstones after truncal vagotomy. Hepatic bile composition was found to be unchanged after truncal vagotomy with Heineke-Mikulicz pyloroplasty in our long-term study. . The data suggest that the alleged increase in the incidence of cholelithiasis after vagotomy and pyloroplasty can be isolated from an effect on the liver. These results may have implications for the preferred course of surgical intervention in certain patients.
Subject(s)
Bile/analysis , Liver/metabolism , Macaca mulatta/metabolism , Macaca/metabolism , Pylorus/surgery , Vagotomy, Proximal Gastric , Vagotomy , Animals , Bile Acids and Salts/analysis , Cholesterol/analysis , Female , Phospholipids/analysisABSTRACT
The ability of Capmul 8210, a commercial solvent that predominantly consists of glyceryl 1-mono-octanoate, to dissolve retained common duct stones by direct infusion into the T-tube was tested in 20 patients with a total of 43 stones. Of 19 patients who completed their infusion, stone disappearance was observed in 15, giving a success rate of 79%. The dissolution time for a single stone averaged four days. A slight rise in serum alkaline phosphatase and amylase levels occurred in some patients, and rapidly returned to normal when treatment was concluded. Other side effects, such as nausea and vomiting epigastric discomfort, or diarrhea, occurred occasionally but were easily controlled medically. We believe that this agent is a useful adjunct in the management of postoperative choledocholithiasis in the patient with an indwelling T-tube.
