It has been reported frequently that clinical features of patients with gallstones in Korea are different from that of Occidentals. These differences were thought to be due to inherent racial difference and aquired from that of Occidentals. These
differences were thought to be due to inherent racial difference and aquired living habits. The accurated analysis of gallstone and bile composition I mandatory to understand the pathophysiology of gallstone formation. We clinically analized 100
caes of
patients with gallstones, biochemically analized bile composition (especially cholesterol, bilirubin, calcium and inorganic phosphorus) of gallbladder in 90 cases gallstone patients and 10 cases with normal gallbladder(control group) who had been
treated surgically at the Department of surgery, Dae Rim Saint Mary's Hospital from Aug. 1991 to July. 1993.
@ES The results were obtained as follows;
@EN 1) The male to female ratio was 1 : 1.4 and peak incidence of age was the 6th decade.
2) The most frequent chief complaint was abdominal pain and physical finding was tenderness on right upper quadrant abdomen.
3) The major positive laboratory tests were leukocytosis, increase of sGOT, sGPT and alkaline phosphatase.
4) The accuracy of diagnostic methods for gallstones were in order of ultrasonogram(90.6%), endoscopic retrograde cholangiopancreaticography(ERCP)(87.5%), computed tomograpy(84.2%) and oral cholecystography(34.6%).
5) Location of gallstones were as follows; 51 cases in gallbladder, 22 cases in common bile duct and 2cases in intrahepatic duct. Multiple stones were found in 75 cases and the remainders(25 cases) had single stone.
6) The bacteral bile culture of galbladder was done in 90 cases and positive in 43(47.7%) cases. The most common bacteria was Escherichia Coli in 26 cases. The positive bile culture rate according to location of gallstones were as follows;
37.3%(19/51)
in gallbladder stone, 53.3%(8/15) in common bile duct stone, 63.6%(7/11) in gallbladder and common bile duct stone, 66.7%(2/3) in gallbladder, common bile duct and intrahepatic duct stone, 70%(7/10) in common bile duct and intrahepatic duct stone
or
intrahepatic duct stone.
7) The biochemical analysis of gallbladder bile composition in 90 cases gallstone patient and 10 cases with normal gallbladder had obtained by aspirating with syringe during laparotomy.
The content of bilirubin, calcium and inorganic phophorus except for decrease cholesterol in gallbladder bile of patients with gallstones were not significantly compared with normal gallbladder bile content(p<0.05). The cholesterol, bilirubin,
calcium
and inorganic phosphorus content in gallbladder bile of patients with gallstones were significantly decreased in infected bile than in non infected bile(p<0.05).
These results suggest tat gallbladder bile composition in gallstone patients could be changed during passage in biliary tract due to bile stasis, mucosal reabsorption of gallbladder and role of bacteria.
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