There are enthusiasms in dissolving gallstones in recent year. But one of main problems of dissolving gallstones is that its effect is only limited to cholesterol contained gallstones. Dissolving gallstones may effective more on occidental gallstone compare with oriental gallstone, which contains more pigment stone. To be effective of dissolving gallstone therapy, we should be able to predict gallstone component accurately by simple method in vivo. There are several available predicting markers for cholesterol-contained gallstone, such as radio-lucency of gallstone, floating, faceted and smooth surface of gallstone and cholesterol in duodenal bile. Among these marker radiolucency is the most useful marker, at present time. To find out effectivness of cholangiogram to predict gallstone components especially in Korean, gallstone components were analized in 100 cases of gallstone, which extracted in Korean patients. At same time, radiographic opacification of stones were compared with components.
There are 18 radiolucent stones, 22 strong opaque stones and 60 mild opaque stones. Among 18 radiolucent stone, there are 15(72.2%) cholesterol-contained stone. In contrast, 15 out 22 strong(68%) opaque stones are cholesterol abscent stone. It´was difficult to predict component in mild opaque stone because there are 31 case (51.6%) of cholesterol contain stone and 29(48.3%) cholesterol abscent stone in mild opaque stone.
If you have a patient with radiolucent gallstone, you can reasonably predict cholesterol-contained stone and can use dissolving agents. But in case of strong radiopaque stone, you should not use dissolving agents because it is most probably cholesterol abscent stones. In mild opaque stone, you have to use other predicting markers such as smooth surface of stone, faceted stone and floating stone before using dissolving agents.
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