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

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Abstract
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)