Comparing Core,Rim and Peripheral Composition of Intraductal Gallstones by Infrared Spectroscopy

Abstract:

Intraductal (common bile duct or intrahepatic duct) gallstones were rather prevalent in Asia and Taiwan.Comparing composition difference among central cores,rims and peripheries is help full to determine etiology in the process of stone nidation.Twenty sets of intraductal stones,including black pigment stone (n=2) and brown pigment stones (n=18),were quantitated by Infrared Spectroscopy.In brown pigment stones,12 sets of stones presented rim structure (rim stones) with cholesterol content in 5 cases but without cholesterol in 7 cases,and other 6 stones showed muddy appearance.Comparing compositions of brown pigment intraductal rim stones,the median content of calcium bilirubinate always presents peripheries>rim>central core with or without cholesterol content (core vs.peripheries,P<0.05).The distribution of calcium palmitate shows central core>rim>peripheries in rim stones without cholesterol (core vs.peripheries,P<0.05),or in rim stones with cholesterol (core vs.peripheries P>0.05. The median cholesterol content in rim stones with cholesterol content showed central core>rim without significance (P>0.05).The same significant difference of calcium bilirubinate and palmitate contents also present between central core of rim stones and muddy stones (P<0.05).From brown pigment stones,central core contains a significantly larger amount of calcium palmitate representing bacterial infection as a major pathological factor in early nidation of stone formation.On the contrary,calcium bilirubinates always significant present in peripheries and rims of rim structure stones and muddy stones,representing bile stasis as a important factors during stone growth.

Key words:

FT-IR;gallstone;composition;calcium bilirubinate complexes;cholesterol

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