EFFECT OF COLECTOMY WITH ILEOANAL ANASTOMOSIS ON THE BILIARY LIPIDS

Citation
G. Galatola et al., EFFECT OF COLECTOMY WITH ILEOANAL ANASTOMOSIS ON THE BILIARY LIPIDS, European journal of clinical investigation, 25(7), 1995, pp. 534-538
Citations number
24
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Medicine, Research & Experimental","Medicine, General & Internal
ISSN journal
0014-2972
Volume
25
Issue
7
Year of publication
1995
Pages
534 - 538
Database
ISI
SICI code
0014-2972(1995)25:7<534:EOCWIA>2.0.ZU;2-H
Abstract
Total colectomy with ileo-anal anastomosis is an effective treatment f or ulcerative colitis and familial adenomatous polyposis. The absence of the colon and the coexistence of bile acid malabsorption may increa se bile lithogenicity, but data on biliary lipid composition in patien ts with this operation is lacking. Our aim was to assess bile lithogen icity, bile composition and mass of biliary lipids within the gallblad der. We studied 11 patients with total colectomy and ileo-anal anastom osis and 16 healthy controls. We measured the percentage composition o f conjugated bile acids and the masses within the gallbladder of the t hree main biliary lipids. This method, in contrast with measurement of cholesterol saturation index, can determine the cause of bile lithoge nicity in terms of absolute modifications of the biliary lipids. There was no difference in the cholesterol saturation index between patient s and controls. Colectomy patients had reduced masses of all three bil iary lipids (medians and ranges, mmol): cholesterol 0.11 (0.03-0.24) v s. 0.36 (0.02-0.96), P < 0.02; bile acid 1.62 (0.75-5.21) vs. 3.95 (1. 27-8.70), P < 0.01; phospholipids 0.35 (0.07-0.69) vs. 1.14 (0.14-3.00 ), P < 0.002. They also had reduced per cent deoxycholic acid: 3.8 (0. 0-27.6) vs. 17.4 (6.4-44.7), P < 0.005, and increased percent cholic a cid: 44.9 (23.3-71.4) vs. 34.3 (19.2-57.9), P < 0.05. We conclude that , despite having bile acid malabsorption, patients with colectomy and ileo-anal anastomosis have a normal cholesterol saturation index, caus ed by a concomitant reduction in the masses of all three biliary lipid s. The reduced per cent biliary deoxycholic acid may help explain the reduced cholesterol and phospholipid masses in these patients. Total c olectomy with ileoanal anastomosis does not seem to predispose to the formation of cholesterol gallstones.