Citrate: a Component of Bile and Calcium Chelator in Gallbladder Disease

Abstract

Citrate, a calcium chelator, was found to be a regular component of bile in the majority of patients with cholelithiasis. The elevation of citric acid levels was investigated in patients with indwelling T-tubes that were indicative of bile duct exploration for retained bile duct stones following cholecystectomy. The concentration of citrate in gallbladder bile in patients at cholecystectomy was variable. The mean (SEM) 95% confidence interval (CI) concentration in gallbladder bile was 57.8 (4.9) 48.2-67.3 with a range of 0-406 μmoles l-1, and in bile duct bile was 39.6 (11.2) 17.5-61.6 with a range of 0-200 μmoles l-1. Gallbladder or common duct bile infected with bacteria with at least one species with a CFU of ≥ 105 recorded significantly lower citrate concentrations. It was not possible in this study significantly to infer that gallbladder bile associated with a particular stone type had an increased or decreased citric acid content. In 7 of 12 patients with indwelling T-tubes owing to choledocholithia...