Biliary lipids and the paucity of cholesterol gallstone disease in Zambia

Abstract

The concept that cholesterol gallstone formation is the result of precipitation of cholesterol from super-saturated bile has been confirmed by the demonstration that gallstone-containing bladder bile had a concentration of cholesterol at or near the limit of its solubility (Admirant and Small,1968). Apparently closing a prolonged debate as to whether the primary defect was in the hepatic cell or in the gallbladder, the demonstration that hepatic bile from gallstone patients is saturated or supersaturated with cholesterol has led to the widely held view that cholesterol gallstone disease results from a derangement of liver metabolism(Vlahcevic et al, 1970) Some workers consider that this derangement of metabolism is due to an external factor such as diet. The evidence implicates the Western type of diet comprising largely of refined foods and in particular sucrose. Cholesterol gallstone disease has become increasingly common among the Japanese, for example, since their introduction of a Western way of life.