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IV Chenodeoxycholate Prevents Calcium Bilirubinate Gallstones During Total Parenteral Nutrition in the Prairie Dog

Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, Nebraska

Robert J. Fitzgibbons, JR, MD, FACS

Department of Surgery, Creighton University School of Medicine, Omaha, Nebraska

Roger W. Geiss, MD

Department of Pathology, Creighton University School of Medicine, Omaha, Nebraska

Thomas E. Adrian, PHD, MRC PATH

Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, Nebraska

Gary Anthone, MD

Department of Surgery, Creighton University School of Medicine, Omaha, Nebraska

Background: The purpose of this study was to determine whether IV chenodeoxycholate (CDC) could prevent total parenteral nutrition (TPN)-associated pigmented gallstones in the prairie dog. Methods: Twelve prairie dogs were divided into two equal groups, each receiving an identical TPN regimen. Each animal received 92 kcal/d with 61% of the calories from carbohydrate. The total volume of infusate delivered to each animal was 59 mUd. Animals in one group, termed the TPN + CDC group, received a daily bolus injection of CDC at a dose of 15 mg/kg. Prairie dogs in the second group, termed the TPN group, received water (vehicle carrier) 1 mL/kg/d. The TPN and TPN + CDC groups received TPN for 40.3 ± 1.3 and 42.5 ± 0.6 days, respectively. Results: There was no statistical difference in the initial and final weights between the two groups. None of the TPN + CDC-treated animals had gallstones or calcium bilirubinate crystals. In contrast, all of the TPN-treated animals had calcium bilirubinate crystals (p = .002), and five of six had macroscopic black pigmented gallstones (p = .015). Cholesterol crystals were not observed in either group of animals. The amount of biliary bilirubin and ionized calcium was significantly greater in the TPN group (both P < .001); however, both groups had a similar total biliary calcium concentration. Conclusion: IV CDC is effective in preventing TPN-associated gallstones in the prairie dog. (Journal of Parenteral and Enteral Nutrition 20:187-193, 1996)

Journal of Parenteral and Enteral Nutrition, Vol. 20, No. 3, 187-193 (1996)
DOI: 10.1177/0148607196020003187


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