Malet P F, Dabezies M A, Huang G H, Long W B, Gadacz T R, Soloway R D
Gastrointestinal Section, University of Pennsylvania School of Medicine, Philadelphia.
Gastroenterology. 1988 May;94(5 Pt 1):1217-21. doi: 10.1016/0016-5085(88)90015-7.
The aim of this study was to determine the composition of gallstones from the common bile duct of patients from the United States and the relationship of stone type to the time interval after cholecystectomy. We analyzed 56 sets of common bile duct gallstones collected over a 10-yr period using infrared and atomic absorption spectroscopy and chemical methods. Twenty-four sets (43%) of stones were cholesterol stones containing 85.3% cholesterol, 3.2% pigment, 0.6% phosphate, and 1.3% total calcium. Ten sets (18%) were black pigment stones containing 36.5% pigment, 11.4% cholesterol, 7.6% carbonate, 3.0% phosphate, and 6.2% total calcium. Twenty-two sets (39%) were brown pigment stones containing 52.7% pigment, 16.5% calcium palmitate, 10.1% cholesterol, 0.4% phosphate, and 3.4% total calcium. Most of the 26 stones found at the same time as or within several months after cholecystectomy were either cholesterol (69%) or black pigment (19%). In contrast, the majority (59%) of the 22 common duct stones that were diagnosed greater than or equal to 21 mo after cholecystectomy were brown pigment stones. In conclusion, brown pigment stones are a distinct type of pigment stone characterized by their content of substantial amounts of calcium palmitate. They comprise a significant proportion of common duct stones in this series of United States patients, particularly of those found greater than or equal to 21 mo after cholecystectomy.
本研究的目的是确定来自美国患者胆总管结石的成分，以及结石类型与胆囊切除术后时间间隔的关系。我们使用红外光谱、原子吸收光谱和化学方法，分析了在10年期间收集的56组胆总管结石。24组（43%）结石为胆固醇结石，含85.3%胆固醇、3.2%色素、0.6%磷酸盐和1.3%总钙。10组（18%）为黑色色素结石，含36.5%色素、11.4%胆固醇、7.6%碳酸盐、3.0%磷酸盐和6.2%总钙。22组（39%）为棕色色素结石，含52.7%色素、16.5%棕榈酸钙、10.1%胆固醇、0.4%磷酸盐和3.4%总钙。在胆囊切除术后同时或数月内发现的26颗结石中，大多数为胆固醇结石（69%）或黑色色素结石（19%）。相比之下，在胆囊切除术后21个月或更长时间被诊断出的22颗胆总管结石中，大多数（59%）为棕色色素结石。总之，棕色色素结石是一种独特的色素结石类型，其特征是含有大量棕榈酸钙。在这组美国患者中，棕色色素结石在胆总管结石中占相当大的比例，尤其是在胆囊切除术后21个月或更长时间发现的结石中。
