The effects of cholecystectomy on the hepatic secretion rates of biliary lipids and the relative lipid composition of hepatic bile were examined in 8 American Indian patients with cholesterol gallstones. Using a marker dilution technique, the hepatic secretion rates of cholesterol, bile acids, and phospholipids were measured during continuous duodenal infusion of formula before and several months after cholecystectomy. Before surgery, the Indian patients with gallstones secreted hepatic bile that was more lithogenic than that in a group of white women without stones. When bile was sampled under identical conditions after cholecystectomy, there was no change in biliary lipid composition or in hepatic secretion rates. Thus, cholecystectomy apparently does not correct the defect leading to lithogenic bile in these patients.
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