Ruíz de Aguiar A, Medina J A, Garrido G, Villacorta J, Berenguer J
Departamento de Medicina, Hospital Universitario de San Carlos, U.C.M.
Rev Esp Enferm Dig. 1992 May;81(5):327-32.
We have studied thirteen biliary stones resistant to biliary acids, using technical methods of stereomicroscopy, scanning electronic microscopy and EDX analyses. We have investigated changes on surface. Three biliary stones did not change and were considered resistant. Seven biliary stones appear partially dissolved and we observed many irregularities on surface and/or concentric dips in relation with cholesterol dissolution. In six cases, biliary pigment alternates with cholesterol. In three cases we observed a calcium carbonate coat on surface. One case included organic fibers. One biliary stone showed cholesterol with spherical bodies of calcium carbonate and pigment. It was a relapsed case of combined treatment. Three stones are composed of small black portions of polymerized calcium bilirubinate, rich in copper and iron. Our results demonstrate that biliary stones previously selected for treatment are a heterogeneous group. Because of this fact we get variable and unpredictable results.
我们使用体视显微镜、扫描电子显微镜和能谱分析等技术方法，对13颗对胆汁酸有抗性的胆石进行了研究。我们研究了其表面变化。3颗胆石没有变化，被认为具有抗性。7颗胆石出现部分溶解，我们观察到其表面有许多不规则之处和/或与胆固醇溶解相关的同心凹陷。在6个病例中，胆色素与胆固醇交替出现。在3个病例中，我们观察到表面有一层碳酸钙包膜。1个病例中有有机纤维。1颗胆石显示胆固醇伴有碳酸钙和色素的球形体。这是联合治疗的复发病例。3颗胆石由聚合胆红素钙的小黑块组成，富含铜和铁。我们的结果表明，先前选择用于治疗的胆石是一个异质性群体。由于这一事实，我们得到了可变且不可预测的结果。
