Common bile duct stones are mainly brown and associated with duodenal diverticula.
This study investigated the composition of common duct gall stones from 61 patients, aged 49-94. The stones were collected endoscopically with a dormia basket after endoscopic papillotomy. The cholesterol content was measured both by infrared spectroscopy (mean 29%, range 0-99%) and enzymatically (mean 23%, range 0-96%). The results of the two measurements showed good correlation (r2 = 0.92), indicating that cholesterol can be adequately measured enzymatically. Most of the stones were pigment stones. When examined by infrared spectroscopy, 44 stones (72%) contained less than 50% cholesterol (mean 4%, range 0-23%). The bilirubinate content in these stones was 56%, range 12-100%. Forty two of these stones were brown stones, and only two were black stones. Pigment stones were associated with juxtapapillary diverticula (p < 0.01). It was found that brown pigment stones were the commonest symptomatic bile duct calculi in the patients studied, who are representative of a Western population.
Sandstad
O
O
Medical Department, Ullevål Hospital, University of Oslo, Norway.
Osnes
T
T
Skar
V
V
Urdal
P
P
Osnes
M
M
D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000032:analysis; D002784:Cholesterol / Q000032:analysis; D004240:Diverticulum / Q000378:metabolism*; D004378:Duodenal Diseases / Q000378:metabolism*; D016145:Endoscopy, Digestive System; D005260:Female; D042882:Gallstones / Q000737:chemistry* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010858:Pigmentation; D017550:Spectroscopy, Fourier Transform Infrared
D002784:Cholesterol; D001663:Bilirubin