Stone formation in gall bladder is enhanced by all except
Vagal stimulation increases GB motility and prevents Gallstone formation Factors responsible for formation of gallstones Lithogenic bile Increased biliary cholesterol--Obesity, cholesterol rich in diet, clofibrate therapy Decreased Bile acids - Primary biliary cirrhosis, OCP's, mutation of CYP7A1 gene, impaired enterohepatic circulation of bile acids Decreased Biliary Lecithin - MDR-3 gene mutation leads to defective secretion in bile Nucleation Cholesterol monohydrate Crystal aglomerate to become macroscopic crystal by nucleation Pro-nucleating factors - Mucin, Non-Mucin, Infection Anti-Nucleating factors - Apolipoprotein A-1 and A-II Excess of Pro-nucleating factors or deficiency of Anti-Nucleating factors results in formation of gall stones Stasis or GB hypomotility Prolonged TPN Prolonged fasting Pregnancy Octreotide OCP's Massive burns Ref: Sabiston 20th edition Pgno : 1492
Clofibrate therapy
Ileal resection
Cholestyramine therapy
Vagal stimulation
G.I.T