Which among the following does NOT lead to pigment gallstone?
Correct Answer: TPN
Description: Total parenteral nutrition (TPN) is associated with cholesterol and mixed stones. They develop sludge and stones due to stasis as there is no stimulus for contraction. Predisposing factors for pigment gallstone formation: Demographic/genetic factors: Asia, rural setting Chronic hemolysis Alcoholic cirrhosis Pernicious anemia Chronic biliary tract infection, parasitic infection (Escherichia coli, Ascaris lumbricoides, Clonorchis sinensis) Increased age Ileal disease, Ileal resection or bypass Cystic fibrosis Ref: Bailey & Love 25/e, Page 1120; Maingot's 10/e, Page 1720; Harrison 17/e, Page 1993; Robbins 8/e, Page 883
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