The effect of biliary sphincterotomy on serum cholesterol levels in postcholecystectomy patients

A pilot study

Waleed M. Alazmi, Evan Fogel, James L. Watkins, Lee McHenry, Stuart Sherman, Glen Lehman

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 languageEnglish
Pages (from-to)81-84
Number of pages4
JournalCanadian Journal of Gastroenterology
Volume21
Issue number2
StatePublished - Feb 2007

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Cholesterol
Serum
Endoscopic Retrograde Cholangiopancreatography
Hypercholesterolemia
Sphincter of Oddi Dysfunction
Enterohepatic Circulation
Lipids
Symptom Assessment
Liver Function Tests
HDL Lipoproteins
Bile Ducts
Bile Acids and Salts
LDL Lipoproteins
Ileum
Bile
Small Intestine
Stents
Databases
Prospective Studies
Exercise

Keywords

  • Biliary sphincterotomy
  • Cholesterol levels
  • Postcholecystectomy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "The effect of biliary sphincterotomy on serum cholesterol levels in postcholecystectomy patients: A pilot study",
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.",
keywords = "Biliary sphincterotomy, Cholesterol levels, Postcholecystectomy",
author = "Alazmi, {Waleed M.} and Evan Fogel and Watkins, {James L.} and Lee McHenry and Stuart Sherman and Glen Lehman",
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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.

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