Chronic cholelithiasis and decreased bile salt pool size: cause or effect?

The hypothesis that the decreased bile salt pool size observed in humans with chronic cholelithiasis is a result rather than a cause of gallstones was tested in a prairie dog gallstone model. A decrease in bile salt pool size was observed in cholesterol-fed prairie dogs only after the chronic presence of stones had induced physiologic, anatomic and microscopic changes typical of human chronic cholecystitis. These data suggest that the decreased bile salt pool size associated with chronic cholelithiasis is a result rather than a cause of gallstones and that the link between the hepatic secretion of cholelithogenic bile and gallstones is altered gallbladder function.