Bile Formation and Pathophysiology of Gallstones

David Q.H. Wang, Piero Portincasa, Helen H. Wang

Research output: Chapter in Book/Report/Conference proceedingChapter

11 Scopus citations


Gallstone disease is one of the most prevalent digestive diseases worldwide, leading to a considerable financial and social burden. Epidemiological and clinical studies have clearly demonstrated that a complex genetic basis plays a key role in determining individual predisposition to develop gallstones in response to environmental factors. For cholesterol gallstones, the primary pathogenic factor is persistent hepatic hypersecretion of biliary cholesterol induced by multiple Lith genes, with insulin resistance as part of the metabolic syndrome interacting with environmental cholelithogenic factors to cause the phenotype. Pigment gallstones are caused by abnormal bilirubin metabolism and are pigmented, associated with or without biliary infection, as a result of massive precipitation of unconjugated bilirubin and calcium bilirubinate. The latest advances in the gallstone pathogenesis will facilitate the development of a novel, effective, and noninvasive therapy for patients with gallstones.

Original languageEnglish (US)
Title of host publicationEncyclopedia of Gastroenterology, Second Edition
Number of pages20
ISBN (Electronic)9780128124604
StatePublished - Jan 1 2019
Externally publishedYes


  • Bile
  • Bile acid
  • Bile flow
  • Biliary sludge
  • Bilirubin
  • Cholesterol crystallization
  • Gallbladder hypomotility
  • Gut microbiota
  • Hepatic secretion
  • Liquid crystals
  • Lith gene
  • Micelle
  • Mucin
  • Phospholipid
  • Vesicle

ASJC Scopus subject areas

  • Medicine(all)


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