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What is Stone formation in gall bladder is enhanced by all except and explain in detail?
Vagal stimulation increases GB motility and prevents Gallstone formation Factors responsible for formation of gallstones Lithogenic bile Increased biliary cholesterol--Obesity, cholesterol rich in diet, clofibrate therapy Decreased Bile acids - Primary biliary cirrhosis, OCP's, mutation of CYP7A1 gene, impaired enterohepatic circulation of bile acids Decreased Biliary Lecithin - MDR-3 gene mutation leads to defective secretion in bile Nucleation Cholesterol monohydrate Crystal aglomerate to become macroscopic crystal by nucleation Pro-nucleating factors - Mucin, Non-Mucin, Infection Anti-Nucleating factors - Apolipoprotein A-1 and A-II Excess of Pro-nucleating factors or deficiency of Anti-Nucleating factors results in formation of gall stones Stasis or GB hypomotility Prolonged TPN Prolonged fasting Pregnancy Octreotide OCP's Massive burns Ref: Sabiston 20th edition Pgno : 1492