To clarify the mechanisms of stone formation in gallbladder and in common bile duct, the bile composition, such as cholesterol, total bile acid, major bile acids, phospholipid, protein and calcium, from patients with gallbladder stones, common
bile
duct
stones and control groups were analyzed for comparison. The control group consisted of patients who had neither biliary stone nor biliary tract disease.
@ES The results are as follows:
@EN 1) In the mean concentrations of bile cholesterol and protein from each disease group, no statistically significant difference of these compositions was observed according to sorts of stone(p>0.05).
2) In the cholesterol stone group the mean concentration of total bile acid of bile from the gallbladder stone group was higher than that of the common bile duct stone group(p<0.05). In the pigment stone group, the T/D ratio of bile from
gallbladder
stone group tended to be higher than that of the CBD stone group. But these differences were not statistically significant(p=0.09).
3) In the pigment stone groups, the mean concentration of bile phospholipid from gallbladder stone group was significantly higher than that of the CBD stone group(p<0.05).
4) The mean concentration of bile protein from the gallbladder stone group was higher than that of the CBD stone group in the pigment stone group(p<0.05).
5) The mean concentration of bile calcium was significantly higher in the gallbladder stone group than that in the CBD stone group(p<0.05).
In conclusion, supersaturation of cholesterol in bile may not be sufficient to explain cholesterol gallstone formation. The increased in total bile acid especially LCA, DCA, and CDCA may be involved in cholesterol gallbladder stone formation,
whereas
pigment gall bladder stone formation is thought to be related to a decreased T/D ratio of bile which means high dihydroxycholanic acid of bile. Additionally, the results suggest that phospholipid, protein and calcium contribute to pigment
gallbladder
stone formation by playing great roles in forming matrix as nucleus in pigment stone, but further investigation may be needed to detect calcium ion critical for calcium crystal formation
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