The Analysis of the Cholesterol Contents of Intrahepatic Duct Stones in the West Gyeongnam Region

ABSTRACT

PURPOSE: Hepatolithiasis is a recurrent disease and common in Far East Asia. In Korea, almost all intrahepatic duct (IHD) stones were pigment stones 30~40 years ago. The nationwide cooperative study showed a higher cholesterol content of IHD stones compared to the previous data. Some reports have shown a close relationship between urbanization and the cholesterol content of stones. The purpose of this study was to evaluate the cholesterol content of IHD stones in the West Gyeongnam region and evaluate the associated clinical and demographic variables. METHODS: The IHD stones were removed surgically from twenty patients who had hepatolithiasis between July 2005 and April 2007. The stones were grouped by their gross findings. The cholesterol contents were measured quantitatively by infrared spectrophotometry and compared with the clinical variables. RESULTS: Among twenty patients, 19 had pigment stones and only one had gross evidence of a cholesterol stone. The cholesterol content of the stones were 30%~50% in 13 patients, 50~70% in 6 patients and over 70% in one patient. In urban patients, the cholesterol contents of the IHD stones were higher (567.029 mg/g) than in rural patients (421.822 mg/g)(p<0.05). All stones in rural patients were pigment stones; the stones of urban patients consisted of 5 pigment, 6 mixed and 1 cholesterol stone (p<0.05). CONCLUSION: The mean cholesterol content of the IHD stones was 508.946 mg/g; the content of the stone was significantly related to the residence of the patients. These results suggest that the cholesterol content of IHD stones are likely to increase in West Gyeongnam as urbanization increases.