Phospholipids in Human Hepatic Bile, Gall Bladder Bile, and Plasma in Cases with Acute Cholecystitis

Abstract

The composition of phospholipids in hepatic bile, gall bladder bile, and plasma from 18 patients operated on for acute cholecystitis was compared to the corresponding composition in 11 patients operated on for uncomplicated gall stone disease or peptic ulcer. In acute cholecystitis the relative and absolute concentration of lysolecithin was found to be decreased in plasma and increased in hepatic bile. The absolute as well as the relative concentration of all the phosphatides in the gall bladder bile varied widely in cases with acute cholecystitis, which probably reflects a variation in the resorption of the content of the diseased gall bladder. In cases with colourless bile in the gall bladder all the phosphatides occurred in very low concentrations. However, the relative concentration of lysolecithin in the ‘cholecystic’ gall bladders was found to be significantly increased and in three cases the absolute concentration of this phosphatide was found to be very high. The increased concentration of lysolecithin in bile from cases with acute cholecystitis may be caused by extrahepatic hydrolysis of lecithin, and evidence in favour of this interpretation is given. Whether the increased concentration of lysolecithin in bile is primary or secondary to the acute cholecystitis cannot be answered by the present investigation.