Bile Composition in Healthy and Gallstones Patients

NCT ID: NCT03981315

Last Updated: 2019-06-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

62 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-10-31

Study Completion Date

2022-06-30

Brief Summary

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Determine differences between lithogenic and non-lithogenic bile composition.

Detailed Description

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Gallstones constitute an entity known from antiquity, which have been found even in Egyptian mummies. In elder Greece, Tralliano discovered that gallstones are formed in the liver. Vesalio and Falopio described gallstones inside de gallbladder after a human body dissection and in 1882 Langenbuch performed the first cholecystectomy with good results, becoming the gold standard technique for cholelithiasis.

Nowadays, this pathology represents a public health problem in developed countries due to its high prevalence, which is getting higher, estimated between a 10 and a 15% of the population.

However, gallstones are asymptomatic in the 80% of the cases. In 5 years, a 10-20% of these patients will become symptomatic. The global risk of generating symptoms is about a 2% per year, meanwhile biliary tract complications in asymptomatic patients represent a 0'3% per year.

There are two main types of gallstones. The most common of them (70%) are cholesterol stones, composed of \>50% of cholesterol. The other 30% are black pigment stones, with less than 20% of cholesterol in their composition.

The common ways on gallstone formation are: cholesterol supersaturation (due to a liver oversecretion); defects on gallbladder absorption, secretion and motility mechanisms; and higher percentage of deoxycholic acid in the biliary acids due to a slower intestinal movement. All of that leads to supersaturation and cholesterol nucleation.

Black pigment stones are formed of calcium bilirrubinate. The formation mechanism is not clearly defined, but there is an increment in not conjugated bilirubin levels, which is less soluble in water. These gallstones are more frequent in patients who show higher levels of this bilirubin, such as those with hemolysis, Gilbert syndrome or hereditary spherocytosis. They are also common in patients with Crohn disease (specially in those with ileal resection) and cystic fibrosis, in which exists an enterohepatic circulation alteration, driving to an increase on biliary salts and non-conjugated bilirubin levels.

Our work hypothesis is that bile composition in patients with gallstones on the gallbladder is different from those who doesn't show lithiasis.

Conditions

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Cholelithiasis Gall Stone Gall Bladder Disease

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Lithogenic bile in symptomatic patient

Patients who are performed a cholecystectomy as a treatment of their gallbladder disease

Bile test

Intervention Type DIAGNOSTIC_TEST

Analyze bile components related to gall stones synthesis (cholesterol, bile acids, phospholypids, etc.)

Blood test

Intervention Type DIAGNOSTIC_TEST

Analyze blood components related to gall stones synthesis (cholesterol, bile acids, phospholypids, etc.)

Gall stone study

Intervention Type DIAGNOSTIC_TEST

Study of the extracted gall stones, analyzing their composition, type, etc.

Microbiological bile test

Intervention Type DIAGNOSTIC_TEST

Determination of the microbiological composition of the bile

Lithogenic bile in asymptomatic patient

Patients who are performed a cholecystectomy for another reason (cancer, organ donation) and gall stones are found

Bile test

Intervention Type DIAGNOSTIC_TEST

Analyze bile components related to gall stones synthesis (cholesterol, bile acids, phospholypids, etc.)

Blood test

Intervention Type DIAGNOSTIC_TEST

Analyze blood components related to gall stones synthesis (cholesterol, bile acids, phospholypids, etc.)

Gall stone study

Intervention Type DIAGNOSTIC_TEST

Study of the extracted gall stones, analyzing their composition, type, etc.

Microbiological bile test

Intervention Type DIAGNOSTIC_TEST

Determination of the microbiological composition of the bile

Non-lithogenic bile

Patients who are performed a cholecystectomy for another reason (cancer, organ donation) without gall stones

Bile test

Intervention Type DIAGNOSTIC_TEST

Analyze bile components related to gall stones synthesis (cholesterol, bile acids, phospholypids, etc.)

Blood test

Intervention Type DIAGNOSTIC_TEST

Analyze blood components related to gall stones synthesis (cholesterol, bile acids, phospholypids, etc.)

Microbiological bile test

Intervention Type DIAGNOSTIC_TEST

Determination of the microbiological composition of the bile

Interventions

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Bile test

Analyze bile components related to gall stones synthesis (cholesterol, bile acids, phospholypids, etc.)

Intervention Type DIAGNOSTIC_TEST

Blood test

Analyze blood components related to gall stones synthesis (cholesterol, bile acids, phospholypids, etc.)

Intervention Type DIAGNOSTIC_TEST

Gall stone study

Study of the extracted gall stones, analyzing their composition, type, etc.

Intervention Type DIAGNOSTIC_TEST

Microbiological bile test

Determination of the microbiological composition of the bile

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Patients included for an elective cholecystectomy.
2. Normal hepatic and renal function.
3. Able to understand the nature of the study.
4. Wish to participate in the study and sign the informed consent.


1. Patients included for an hepatectomy with gallbladder exeresis for surgery reasons, without lithiasis.
2. Patients included for peritoneal carcinomatosis surgery with gallbladder exeresis for surgery reasons, without lithiasis.
3. Organ donors.
4. Normal hepatic and renal function.
5. Able to understand the nature of the study.
6. Wish to participate in the study and sign the informed consent.

Exclusion Criteria

1. Under 16 years old
2. Hepatic or renal insufficiency
3. Impossibility to understand the aim of the study
Minimum Eligible Age

16 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Son Espases

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Hospital Universitario Son Espases

Palma de Mallorca, Mallorca, Spain

Site Status

Countries

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Spain

Central Contacts

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Alejandro Gil Catalán

Role: CONTACT

695621497

Francesc Xavier Molina Romero

Role: CONTACT

695621497

Facility Contacts

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Alejandro Gil Catalán

Role: primary

695621497

References

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Gibney EJ. Asymptomatic gallstones. Br J Surg. 1990 Apr;77(4):368-72. doi: 10.1002/bjs.1800770405.

Reference Type BACKGROUND
PMID: 2187558 (View on PubMed)

Heller F, Bouchier IA. Cholesterol and bile salt studies on the bile of patients with cholesterol gallstones. Gut. 1973 Feb;14(2):83-8. doi: 10.1136/gut.14.2.83.

Reference Type BACKGROUND
PMID: 4696536 (View on PubMed)

Jayanthi V, Sarika S, Varghese J, Vaithiswaran V, Sharma M, Reddy MS, Srinivasan V, Reddy GM, Rela M, Kalkura S. Composition of gallbladder bile in healthy individuals and patients with gallstone disease from north and South India. Indian J Gastroenterol. 2016 Sep;35(5):347-353. doi: 10.1007/s12664-016-0685-5. Epub 2016 Sep 16.

Reference Type BACKGROUND
PMID: 27633032 (View on PubMed)

Mackay C, Crook JN, Smith DC, McAllister RA. The composition of hepatic and gallbladder bile in patients with gallstones. Gut. 1972 Oct;13(10):759-62. doi: 10.1136/gut.13.10.759.

Reference Type BACKGROUND
PMID: 5087065 (View on PubMed)

Reinhold JG, Ferguson LK, Hunsberger A. THE COMPOSITION OF HUMAN GALLBLADDER BILE AND ITS RELATIONSHIP TO CHOLELITHIASIS. J Clin Invest. 1937 May;16(3):367-82. doi: 10.1172/JCI100864. No abstract available.

Reference Type BACKGROUND
PMID: 16694485 (View on PubMed)

Shaffer EA. Gallstone disease: Epidemiology of gallbladder stone disease. Best Pract Res Clin Gastroenterol. 2006;20(6):981-96. doi: 10.1016/j.bpg.2006.05.004.

Reference Type BACKGROUND
PMID: 17127183 (View on PubMed)

Van Erpecum KJ. Pathogenesis of cholesterol and pigment gallstones: an update. Clin Res Hepatol Gastroenterol. 2011 Apr;35(4):281-7. doi: 10.1016/j.clinre.2011.01.009. Epub 2011 Feb 25.

Reference Type BACKGROUND
PMID: 21353662 (View on PubMed)

Other Identifiers

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BILISGILMOL

Identifier Type: -

Identifier Source: org_study_id

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