Does total parenteral nutrition induce gallbladder sludge formation and lithiasis

摘要: To assess the prevalence of sludge formation and lithiasis during total parenteral nutrition, serial biliary ultrasonographic studies were performed after i.v. nutrition periods in 23 selected adult gastroenterological patients. All patients free hepatobiliary disease before nutrition. Initial sonograms 19 taken at 12th day +/- 2 days (mean SEM) normal. for 4 remaining patients, which on 39th 10 therapy (p less than 0.001), showed gallbladder but did not demonstrate lithiasis. Serial indicated that percentage sludge-positive increased from 6% first 3 wk to 50% between fourth sixth weeks reached 100% receiving nutritional greater 6 wk. Gallstone was demonstrated 14 sludge-forming observed who sludge-negative. Three stone-forming underwent cholecystectomy because complications secondary cholelithiasis a mean 43-day course Analysis bile these revealed thick bile-containing cholesterol crystals small stones mixed bilirubin-cholesterol type. Ultrasonographic obtained period. Sludge positivity decreased 88% oral refeeding 0% by end week. This study, therefore, strongly suggests bowel rest stasis lead production sludge, can result eventual gallstone formation. Consequently, exceeding 1 mo, should be palliated prevent