A Scanning Electron Microscopic Study on the Formation of Cholesterol Stones

Ogata, Takuro; Nishie, Yutaka

doi:10.1620/tjem.113.371

Cited by 8 publications

(1 citation statement)

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“…In fact, this lesion may be the initial microscopic feature of hemolysis-induced pigmlent gallstone disease in mice. Although mucin was not (juantitated in this study, others have demonstrated an increase in mucin production preceding dietary-induced cholesterol stone formation (25)(26)(27). A prospective study is indeed necessary to assess the relationship of mucin to other biochemical parameters in bile.…”

Section: Discussionmentioning

confidence: 52%

Studies on the Pathogenesis of Pigment Gallstones in Hemolytic Anemia

Trotman¹,

Bernstein²,

Bove³

et al. 1980

J. Clin. Invest.

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Section: Discussionmentioning

confidence: 52%

Studies on the Pathogenesis of Pigment Gallstones in Hemolytic Anemia

Trotman¹,

Bernstein²,

Bove³

et al. 1980

J. Clin. Invest.

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The distribution of calcium salt precipitates in the core, periphery and shell of cholesterol, black pigment and brown pigment gallstones

et al. 1994

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Calcium bilirubinate, palmitate, carbonate and phosphate have been identified in the cores of cholesterol and pigment gallstones, suggesting a role for precipitated calcium salts in the early events of gallstone formation. Previous studies that compared the calcium salt contents of cholesterol and pigment stones required destruction of gallstone structure. We have used scanning electron microscopy with windowless energy-dispersive x-ray microanalysis to determine the prevalence of calcium salts in a series of cholesterol (n = 105), black pigment (n = 35) and brown pigment (n = 6) gallstones obtained from 146 consecutive patients undergoing cholecystectomy. These techniques provide specific identification of cholesterol and individual calcium salts as they occur within the core, periphery and shell of gallstones without destroying stone structure. Calcium precipitates more than 0.5 micron in diameter can be detected in a cholesterol background at a detection limit of 0.01% by weight. Calcium salts were detected in the centers of 88% of cholesterol and 100% of black (p < 0.05 vs. cholesterol) and brown pigment stones. Calcium bilirubinate was identified in the cores of 54% of cholesterol and in all pigment stones (p < 0.001 black pigment vs. cholesterol). Calcium palmitate was detected in all brown pigment stones, in 39% of cholesterol stones (p < 0.001 vs. brown pigment) and in 31% of black stones (p < 0.01 vs. brown pigment). Peripheral calcium salts were detected less in cholesterol (19%) than in black or brown stones (100%, p < 0.05). Fourteen percent of cholesterol and black pigment stones were surrounded by shells containing mostly calcium carbonate.(ABSTRACT TRUNCATED AT 250 WORDS)

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