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Bacteria and gallstone nucleation.

L Vitetta1, A Sali, V Moritz

  • 1University of Melbourne Department of Surgery, Heidelberg, Vic., Australia.

The Australian and New Zealand Journal of Surgery
|July 1, 1989
PubMed
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Bacteria may play a role in cholesterol gallstone formation. Specifically, bacteria with beta-glucuronidase activity were linked to cholesterol calculi, unlike black pigment gallstones which showed no bacterial association.

Area of Science:

  • Gastroenterology
  • Microbiology
  • Biochemistry

Background:

  • Cholesterol gallstones are common, but their precise formation mechanisms are not fully understood.
  • The role of bacterial infection in gallstone etiology requires further investigation.

Purpose of the Study:

  • To investigate the potential association between bacterial infection and the formation of cholesterol gallstones.
  • To explore the enzymatic activity of bacteria in relation to gallstone composition.

Main Methods:

  • Bacteriological and microscopic examination of gallbladder bile from 225 patients undergoing cholecystectomy.
  • Analysis of cholesterol calculi for bacterial presence and specific enzyme activity (beta-glucuronidase).
  • Microscopic examination of gallstone composition, including calcium bilirubinate and calcium palmitate.

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Main Results:

  • A significant association was found between cholesterol calculi and gallbladder bile infected with bacteria possessing beta-glucuronidase activity (10.2% of patients).
  • Bile associated with these cholesterol calculi showed high calcium bilirubinate precipitation, with precipitates found in the gallstone centers.
  • Calcium palmitate was detected in the nuclear areas of cholesterol gallstones in approximately half of the affected patients, suggesting bacterial influence.
  • Bacterial infection was notably absent in cases of black pigment gallstones, indicating a different etiology.

Conclusions:

  • Bacteria, particularly those with beta-glucuronidase activity like Escherichia coli, may significantly contribute to the formation of cholesterol gallstones, especially brown pigment gallstones.
  • Bacterial enzymes appear to influence the precipitation of calcium bilirubinate and calcium palmitate within gallstones.
  • Bacteria do not seem to play a role in the formation of black pigment gallstones, as their associated bile is sterile.