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Objective To study the relationship among bile components and different gallstone types through comparing and analyzing gallbladder bile contents in patients with different types of gallstones.Methods A retrospective study of 542 consecutive patients with gallstones or gallbladder polyps was conducted.The stone composition type and 14 kinds of bile components from these patients were analyzed.The bile parameters consisted of potassium (K +),sodium (Na+),chlorine (Cl-),calcium (Ca2+),bicarbonate (HCO3-),magnesium (Mg2+),aspartate aminotransferase (AST),glutamyltranspeptidase (GGT),alkaline phosphatase (ALP),total bilirubin (TBIL),total bile acid (TBA),cholesterol (CHO),lactate dehydrogenase (LDH) and pH.Finally,the content of these bile components among the different types of stones and gallbladder polyps were compared.According to the composition determined by Fourier transform infrared spectroscopy (FTIR),the gallstone patients were divided into five groups.Results Compared with other groups,the content of K +,GGT,ALP,TBIL,TBA and CHO in the calcium carbonate stone group were lower (P ＜ 0.05),while the levels of C1-,HCO3-and value of PH were higher (P ＜0.05).Furthermore,CHO content in the cholesterol stone group was higher than other groups (P ＜ 0.05)except for the gallbladder polyp group (P ＞ 0.05).In addition,there was no difference in bile contents among the pigment gallstone group,mixed stone group and polyp group (P ＞ 0.05).Conclusions In gallstone patients,the bile components of patients with calcium carbonate stones is significantly different.The high cholesterol content in bile is the main feature of cholesterol stone patients,and there is no significant difference in bile composition between patients with pigment stones and mixed stones.
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Objective A systematic study to classify mixed gallbladder stones to determine their relationship with Clonorchis sinensis infection.Methods 349 consecutive patients with mixed gallbladder stones were enrolled into this study and their gallstones were studied.The material composition of gallbladder stones was analyzed using Fourier Transform Infrared spectroscopy,and the distribution and microstructure of the material components were studied using Scanning Electron Microscopy.The composition and distribution of the elements were analyzed by an X-ray energy spectrometer.Gallbladder stones were classified accordingly,and the stones were then grinded for microscopic examination.The stones were divided into two groups based on the results of detection of clonorchis sinensis eggs.Patients were also divided into two groups according to the patients' region (high-incidence and low-incidence regions of Clonorchis sinensis infection).The diversity of the subtypes of mixed gallbladder stones was compared.Results 14 subtypes were found,including Bilirubinate-calcium carbonate mixed stones (n =134),Cholesterol-bilirubinate mixed stones (n =87),Bilirubinate-phosphate mixed stones (n =39),Cholesterol-calcium carbonate mixed stones (n =30),Cholesterol-bilirubinate-calcium carbonate mixed stones (n =15),etc.Bilirubinate-calcium carbonate mixed stones were the main subtype of egg-positive mixed gallbladder stones and the patients were from high-incidence regions.Cholesterol-bilirubinate mixed stones were the main subtype of egg-negative mixed gallbladder stones and patients were from low-incidence regions.The differences of the subtypes constituent between the high-incidence and low-incidence regions groups were significant (P ＜ 0.05),and between the egg-positive and egg-negative groups were also significant (P ＜ 0.05).Conclusions The most common subtypes of mixed gallbladder stones were bilirubinate-calcium carbonate mixed stones,while the second was cholesterol-bilirubinate mixed stones.Clonorchis sinensis infection was mainly associated with Bilirubinatecalcium carbonate mixed stones.
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Objective To study the relationship between Clonorchis sinensis infestation and different types of gallbladder stones.Methods From May 2011 to September 2014, 1 052 cases of gallbladder stones were collected from the Department of General Surgery at The Sixth People's Hospital of Nansha, Guangzhou.These stones were first grinded for microscopic examination and divided into two groups based on the results of detection of Clonorchis sinensis eggs.They were then analyzed by FTIR spectroscopy to identify the type of gallbladder stones.Some stones were also chosen randomly for observation under scanning electron microscope (SEM).Results Clonorchis sinensis eggs were found in 300 stones and among these, the number and proportion of cholesterol, bile pigment, calcium carbonate, mixed and other types of stones were 28 (9.3％), 102 (34.0％), 102 (34.0％), 50 (16.7％), and 18 (6.0％), respectively.In the 752 egg-negative stones, the number and proportion of the above five types of stones were 414 (55.1％), 132 (17.6％), 66 (8.8％), 94 (12.5％), and 46 (6.1％), respectively.Observation under SEM showed a lot of tiny particles were absorbed on the mesh of the superficial texture of the Clonorchis sinensis eggs, which were also adherent to the bilirubin particles, calcium stearate crystals, phosphate, calcium stearate and protein particles.Conclusions The main types of egg-positive stones were bile pigment and calcium carbonate stones, while cholesterol stone was the main type of egg-negative stones.Clonorchis sinensis infestation was associated mainly with bile pigment and calcium carbonate stones.
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Objective To develop a classification of gallbladder stones,to analyze the clinical characteristics of each type of stone and to provide a theoretical basis for the formation of different types of gallbladder stones.Method 925 consecutive patients with gallbladder stones were enrolled and their gallstones were studied.The material composition of the gallbladder stones was analyzed using fourier transform infrared spectroscopy and the distribution and microstructure of the material components were observed using scanning electron microscopy.The composition and distribution of the elements were analyzed by an X-ray energy spectrometer.Gallbladder stones were classified accordingly.Results The gallbladder stones were classified into 8 types and more than ten subtypes,including cholesterol stones (n =334),pigment stones (n =246),calcium carbonate stones (n =167),phosphate stones (n =14),calcium stearate stones (n =11),protein stones (n =3),cystine stones (n =1) and mixed stones (n =149).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.Conclusion The systematic classification of gallbladder stones indicated that different types of stones had different characteristics in terms of infrared spectrogram,microstructure,elemental composition and distribution,thus providing an important basis for the mechanistic study of gallbladder stones.
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Objective To study whether Clonorchis sinensis eggs were involved in the pathogen esis of gallbladder stones.Method From March to August 2011,the gallbladder stones from 183 patients were studied using microscopic examination and FTIR spectroscopy.Twenty egg-positive and 20egg-negative gallbladder stones found under microscopic examination were chosen randomly and analyzed through real-time fluorescent PCR and scanning electron microscopy.Results Eggs were detected in 118 of 183 gallbladder stones.The eggs were preliminarily diagnosed as Clonorchis sinensis eggs using the morphologic characteristics under light microscope.The results of real-time fluorescent PCR showed eggs in the gallbladder stones were Clonorchis sinensis eggs.The 118 egg-positive gallbladder stones were composed of 97 pigment stones,21 mixed stones and no cholesterol stones.The detection rate of Clonorchis sinensis eggs in pigment stones were the highest among the three types of gallbladder stones (P＜0.001).The 20 egg-positive stones were observed by scanning electronic microscopy:dozens or even hundreds of Clonorchis sinensis eggs were visible under 400 times magnification; and a dozen or even dozens of Clonorchis sinensis eggs and the surrounding particles were adherent to or parceled with each other under 1000 times magnification.While under 3000 times magnification,uneven texture was seen on the surface of eggs with pieces being shed from some eggs.Some eggs were hollow or without cover.Most of them were adherent to or wrapped with amorphous particles or mucoid matter.Conclusions A large amount of Clonorchis sinensis eggs were detected in gallbladder stones.Clonorchis sinensis eggs were associated with the formation of gallbladder stones,especially with pig ment stones.
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ObjectiveTo investigate the relationship between intramural gallstones and intraluminal gallstones. MethodsIn this present study, the control study was applied to analysis on the gallstones from 116 cholecystolithiasis patients with intramural gallstones as well as intraluminal gallstones. All the patients were from the general surgery department and accepted gallbladder-preserving cholecystolithotomy during 2009.02-2009.08. Meanwhile, 171 patients with intraluminal gallstones were investigated the clinical traits; and gallstones from them were analyzed with FT-IR and microsopic examination. ResultsThe results showed the coincidence rate of stone type was 97.4％, and it was mainly pigment gallstones and mixed gallstones in 116 cases; the coincident detection rate of clonorchis sinensis eggs was 98.3 ％, and it was much higher in the pigment gallstones and mixed gallstones than that in the cholesterol gallstones. The ratio of pigment gallstones from the 116 patients group was higher than the 171 patients group, and the detection rate of C. sinensis eggs of the two groups had no statistical difference (P＞0.05). ConclusionsThe stone type of intramural gallstones was mainly pigment gallstones and mixed gallstones. Intramural gallstones and intraluminal gallstones were homologous.