The Effect of Intravenous Fat and Total Parenteral Nutrition on Biliary Physiology

Abstract

Patients on long-term total parenteral nutrition (TPN) have an increased incidence of gallstones. To determine the pathophysiologic mechanisms responsible for gallstone formation in these patients, we fed three groups of prairie dogs intravenously for 10 days with continuous infusions of isocaloric, isovolemic, and isonitrogenous solutions with either 0, 25, or 50% of nonprotein calories provided as Intralipid. A fourth group of prairie dogs was hyperalimented with the 25% solution for 28 days. Control animals were fed Purina rat Chow ad libitum. Each animal's bile salt pool was labeled with iv ³H-cholic acid 16 hr prior to collecting gallbladder and hepatic bile specimens. The ratio of gallbladder to hepatic bile ³H-cholic acid specific activity (dpm/mol of bile acid), an index of gallbladder stasis, was significantly (p Journal of Parenteral and Enteral Nutrition8:263-268, 1984)