Kim M H, Sekijima J, Park H Z, Lee S P
Department of Medicine, University of Washington School of Medicine, Seattle, USA.
Dig Dis Sci. 1995 Oct;40(10):2143-51. doi: 10.1007/BF02208998.
We have analyzed the chemical composition of primary intrahepatic stones from 72 Korean patients. Two types of concretions have been identified: brown pigment (calcium bilirubinate) stones and black-colored mixed stones. Brown pigment stones were found in 68% of all cases and the remainder (32%) consisted of mixed stones. Intrahepatic mixed stones had mean cholesterol and bilirubin contents of 46.6% and 25.9%, respectively, whereas calcium bilirubinate stones had mean cholesterol and bilirubin contents of 14.1% and 43.6%, respectively. Intrahepatic mixed stones had a smooth black-colored surface and on cross section, exhibited a distinct outer shell surrounding an inner yellow, cholesterol-rich body. The finding of intrahepatic mixed stones with high cholesterol content suggests that primary hepatolithiasis may result from at least two different conditions or disorders and points to different approaches to their treatment.
我们分析了72例韩国患者原发性肝内结石的化学成分。已鉴定出两种类型的结石：棕色色素（胆红素钙）结石和黑色混合结石。在所有病例中，68%发现为棕色色素结石，其余（32%）为混合结石。肝内混合结石的胆固醇和胆红素平均含量分别为46.6%和25.9%，而胆红素钙结石的胆固醇和胆红素平均含量分别为14.1%和43.6%。肝内混合结石表面光滑呈黑色，横切面上可见一个明显的外壳包裹着内部黄色、富含胆固醇的物体。肝内混合结石胆固醇含量高这一发现表明，原发性肝内胆管结石可能至少由两种不同的情况或病症引起，这也为其治疗指明了不同的方向。
