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Cholesterol Gallstones : Risk Factors

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RAPID WEIGHT LOSS: Rapid weight loss following gastric bypass surgery or strict caloric restriction is a well-known risk factor for the formation of cholesterol gallstones (shown here). The underlying mechanisms include enhanced hepatic secretion of cholesterol, increased mucin production by gallbladder, and reduced gallbladder motility.

TOTAL PARENTERAL NUTRITION: TPN is a risk factor for cholelithiasis and acalculous cholecystitis. Biliary sludge forms in the gallbladder within 3 weeks of prolonged fasting and approximately 50% of patients develop gallstones within 3-4 months of starting TPN. Cholecystokinin octapeptide administered prophylactically is safe and effective in preventing gallstones in such patients.

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