Abstract
Background: Cholesterol, in the form of bile salts, is reabsorbed from the small intestine via the enterohepatic circulation. Biliary sphincterotomy increases the delivery of bile to the terminal ileum. If the absorptive capacity is exceeded, cholesterol excretion may increase, resulting in a decrease in serum cholesterol levels and improvement in serum lipid profiles. Aim: To determine the effect of biliary sphincterotomy on serum cholesterol levels in patients without biliary obstruction. Patients and methods: Postcholecystectomy patients with type III biliary sphincter of Oddi dysfunction (disabling pancreatobiliary-type pain with normal liver function tests and bile duct diameter) who underwent biliary sphincterotomy were identified retrospectively from the endoscopic retrograde cholangiopancreatography database. Baseline (pre-endoscopic retrograde cholangiopancreatography) laboratory investigations (including cholesterol) were obtained for all patients. The effect of sphincterotomy on total cholesterol levels was noted in all patients who returned for subsequent procedures (temporary pancreatic stent removal or evaluation of recurrent symptoms), and also in the subgroup of patients with baseline hypercholesterolemia (higher than 5.18 mmol/L). Results: In the present pilot study, the performance of biliary sphincterotomy was associated with a reduction in total serum cholesterol levels in postcholecystectomy patients without biliary obstruction. This was statistically significant in patients with a baseline cholesterol level higher than 5.18 mmol/L. A possible effect on low-and high-density lipoprotein concentrations was not evaluated. The influence of dietary changes and exercise were not accounted for. Conclusion: A prospective, controlled study involving a larger series of patients is required to determine whether biliary sphincterotomy lowers cholesterol levels and improves lipid profiles.
| Original language | English |
|---|---|
| Pages (from-to) | 81-84 |
| Number of pages | 4 |
| Journal | Canadian Journal of Gastroenterology |
| Volume | 21 |
| Issue number | 2 |
| State | Published - Feb 2007 |
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Keywords
- Biliary sphincterotomy
- Cholesterol levels
- Postcholecystectomy
ASJC Scopus subject areas
- Gastroenterology
Cite this
The effect of biliary sphincterotomy on serum cholesterol levels in postcholecystectomy patients : A pilot study. / Alazmi, Waleed M.; Fogel, Evan; Watkins, James L.; McHenry, Lee; Sherman, Stuart; Lehman, Glen.
In: Canadian Journal of Gastroenterology, Vol. 21, No. 2, 02.2007, p. 81-84.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The effect of biliary sphincterotomy on serum cholesterol levels in postcholecystectomy patients
T2 - A pilot study
AU - Alazmi, Waleed M.
AU - Fogel, Evan
AU - Watkins, James L.
AU - McHenry, Lee
AU - Sherman, Stuart
AU - Lehman, Glen
PY - 2007/2
Y1 - 2007/2
N2 - Background: Cholesterol, in the form of bile salts, is reabsorbed from the small intestine via the enterohepatic circulation. Biliary sphincterotomy increases the delivery of bile to the terminal ileum. If the absorptive capacity is exceeded, cholesterol excretion may increase, resulting in a decrease in serum cholesterol levels and improvement in serum lipid profiles. Aim: To determine the effect of biliary sphincterotomy on serum cholesterol levels in patients without biliary obstruction. Patients and methods: Postcholecystectomy patients with type III biliary sphincter of Oddi dysfunction (disabling pancreatobiliary-type pain with normal liver function tests and bile duct diameter) who underwent biliary sphincterotomy were identified retrospectively from the endoscopic retrograde cholangiopancreatography database. Baseline (pre-endoscopic retrograde cholangiopancreatography) laboratory investigations (including cholesterol) were obtained for all patients. The effect of sphincterotomy on total cholesterol levels was noted in all patients who returned for subsequent procedures (temporary pancreatic stent removal or evaluation of recurrent symptoms), and also in the subgroup of patients with baseline hypercholesterolemia (higher than 5.18 mmol/L). Results: In the present pilot study, the performance of biliary sphincterotomy was associated with a reduction in total serum cholesterol levels in postcholecystectomy patients without biliary obstruction. This was statistically significant in patients with a baseline cholesterol level higher than 5.18 mmol/L. A possible effect on low-and high-density lipoprotein concentrations was not evaluated. The influence of dietary changes and exercise were not accounted for. Conclusion: A prospective, controlled study involving a larger series of patients is required to determine whether biliary sphincterotomy lowers cholesterol levels and improves lipid profiles.
AB - Background: Cholesterol, in the form of bile salts, is reabsorbed from the small intestine via the enterohepatic circulation. Biliary sphincterotomy increases the delivery of bile to the terminal ileum. If the absorptive capacity is exceeded, cholesterol excretion may increase, resulting in a decrease in serum cholesterol levels and improvement in serum lipid profiles. Aim: To determine the effect of biliary sphincterotomy on serum cholesterol levels in patients without biliary obstruction. Patients and methods: Postcholecystectomy patients with type III biliary sphincter of Oddi dysfunction (disabling pancreatobiliary-type pain with normal liver function tests and bile duct diameter) who underwent biliary sphincterotomy were identified retrospectively from the endoscopic retrograde cholangiopancreatography database. Baseline (pre-endoscopic retrograde cholangiopancreatography) laboratory investigations (including cholesterol) were obtained for all patients. The effect of sphincterotomy on total cholesterol levels was noted in all patients who returned for subsequent procedures (temporary pancreatic stent removal or evaluation of recurrent symptoms), and also in the subgroup of patients with baseline hypercholesterolemia (higher than 5.18 mmol/L). Results: In the present pilot study, the performance of biliary sphincterotomy was associated with a reduction in total serum cholesterol levels in postcholecystectomy patients without biliary obstruction. This was statistically significant in patients with a baseline cholesterol level higher than 5.18 mmol/L. A possible effect on low-and high-density lipoprotein concentrations was not evaluated. The influence of dietary changes and exercise were not accounted for. Conclusion: A prospective, controlled study involving a larger series of patients is required to determine whether biliary sphincterotomy lowers cholesterol levels and improves lipid profiles.
KW - Biliary sphincterotomy
KW - Cholesterol levels
KW - Postcholecystectomy
UR - http://www.scopus.com/inward/record.url?scp=33947238414&partnerID=8YFLogxK
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M3 - Article
VL - 21
SP - 81
EP - 84
JO - Canadian Journal of Gastroenterology and Hepatology
JF - Canadian Journal of Gastroenterology and Hepatology
SN - 2291-2789
IS - 2
ER -