The Systematic Classification of Gallbladder Stones

Abstract

BackgroundTo develop a method for systematic classification of gallbladder stones, analyze the clinical characteristics of each type of stone and provide a theoretical basis for the study of the formation mechanism of different types of gallbladder stones.MethodologyA total of 807 consecutive patients with gallbladder stones were enrolled and their gallstones were studied. The material composition of gallbladder stones was analyzed using Fourier Transform Infrared spectroscopy and the distribution and microstructure of material components was observed with Scanning Electron Microscopy. The composition and distribution of elements were analyzed by an X-ray energy spectrometer. Gallbladder stones were classified accordingly, and then, gender, age, medical history and BMI of patients with each type of stone were analyzed.Principal FindingsGallbladder stones were classified into 8 types and more than ten subtypes, including cholesterol stones (297), pigment stones (217), calcium carbonate stones (139), phosphate stones (12), calcium stearate stones (9), protein stones (3), cystine stones (1) and mixed stones (129). Mixed stones were those stones with two or more than two kinds of material components and the content of each component was similar. A total of 11 subtypes of mixed stones were found in this study. Patients with cholesterol stones were mainly female between the ages of 30 and 50, with higher BMI and shorter medical history than patients with pigment stones (P<0.05), however, patients with pigment, calcium carbonate, phosphate stones were mainly male between the ages of 40 and 60.ConclusionThe systematic classification of gallbladder stones indicates that different types of stones have different characteristics in terms of the microstructure, elemental composition and distribution, providing an important basis for the mechanistic study of gallbladder stones.

Composition Difference of Cholesterol-, Pigment- and Mixed-type Gallstones, and Their Formation Mechanisms

“…The distribution of female patients in 30-39 years old was the largest, accounting for 31.4%. Our results were consistent with the literature [7]. The prevalence of gallstones in young people in this study is relative high; it was mainly related to the lifestyle of young people in Shenzhen area.…”

“…It was found that cholesterol gallstones accounted for the majority, followed by type of pigment gallstones. It can be seen from Table 1 that the incidence rate of female patients with gallstones in Shenzhen area was significantly higher than that of male (Male: Female = 7:5), which was consistent with the research result of literature [7].…”

Biochemical constituents of gallstones from indigenous blacks of Nigerian origin

“…21,22 Though more advanced methods of classification have been described in the literature to typify gallstones. 22 Cholesterol stones is the most common of all three gallstones reported in the literature especially in the western population, followed by MS and the PS. 9,10 In this study, 64.7% of gallstones were CS, followed by MS with 22.9% and PS with 12.5% of the gallstones.…”

Chemical analysis of gallstones and quantitative analysis of its biochemical components viz total cholesterol, total bilirubin, calcium and inorganic phosphate

“…Studies on chemical composition of gallstones has been carried all over the world and in various parts of India [1] [2] , but such a study has not yet been carried in the north-eastern region of India. In our present study we have determined the chemical composition of cholesterol, bilirubin, calcium and inorganic phosphate in the gallstones and have classified the gallstones biochemically according to the Japanese classification of gallstones [3] [4] , which classifies gallstones as cholesterol gallstones, mixed gallstones or pigment gallstones according to their cholesterol content. Table.1 Japanese classification of gallstones:…”