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Characteristics of gallbladder bile of infants and children
Z Halpern1, Z Vinograd, H Laufer
1Department of Gastroenterology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Israel.
Insights
Infant bile has lower lipids and bile salts than children's bile, increasing sludge and gallstone risk during total parenteral nutrition.
Area of Science:
- Pediatric Gastroenterology
- Biliary Lipid Metabolism
Background:
- Previous studies on biliary lipids in pediatric populations relied on duodenal aspirates.
- This research utilizes direct gallbladder bile samples for more accurate analysis.
Purpose of the Study:
- To compare the lipid composition of gallbladder bile between infants and children.
- To investigate potential factors contributing to gallstone formation in infants receiving total parenteral nutrition.
Main Methods:
- Direct aspiration of gallbladder bile from infants and children.
- Comprehensive analysis of lipid content, including total lipids, bile salts, and phospholipids.
- Measurement of nucleation time and cholesterol saturation index.
Main Results:
- Infants exhibited significantly lower total lipid content (3.3 g/dl) compared to children (9.1 g/dl).
- Bile salt concentration was markedly lower in infants (43.2 mM) versus children (126.7 mM).
- Infants showed shorter nucleation time and a higher cholesterol saturation index.
Conclusions:
- The distinct lipid profile in infant bile, particularly lower bile salts and higher cholesterol saturation, predisposes them to sludge and gallstone formation.
- These findings highlight the increased risk of cholelithiasis in infants undergoing total parenteral nutrition.
- Direct gallbladder bile analysis provides critical insights into pediatric biliary lipid disorders.
Abstract:
In the past, biliary lipids of infants and children were studied in duodenal aspirates. This study was performed on original bile aspirated from the gallbladder. The analysis of lipids in bile demonstrated a significantly lower total lipid content in the bile of infants than in children (3.3 g/dl vs. 9.1 g/dl). The most prominent difference was demonstrated in the bile salt concentration (43.2 mM vs. 126.7 mM) and thereafter in the phospholipid content. Infants had a shorter nucleation time and a higher cholesterol saturation index than did children. These results may explain the increased tendency of infants to produce sludge and gallstones during total parenteral nutrition.