Abstract
Background: Calculus disease of biliary tract is a major public health problem in north Kashmir and pigment gall stones form a significant portion of gall stones in our region. In this study we prospectively studied 84 cases of pigment gall stones to examine the role of bacteria in the formation of these stones.
 Objective: To study the bacterial aetiology of pigment gall stones.
 Methods: A hospital based prospective study of 84 consecutive cases of pigment gall stones was done from December 2012 to November 2019 and the results of stone culture and bile culture were statistically analysed. Informed consent was obtained from all the patients in the study group.
 Results: A total of 84 cases studied included 32 (38.09%) male patients and 52(61.91%) females patients. The median age was 48.5 years and mean age was 46.2 years. Of 84 patients, 21(25.00%) had black pigment stones and 63 (75.00%) had brown pigment stones. 61 (72.62%) patients presented with biliary colic and 24(28.57%) patients had chronic cholecystitis . Bile culture was positive in 46 (54.76%) patients and stone culture was positive in 70(83.33%) patients.
 Conlusion: A strong association was observed between stone culture and bile culture results (showing similar beta-glucronidase producing bacteria) and pigment stone formation.
Highlights
Gall stone disease is known to mankind since ancient times.[1]
In this study we prospectively studied 84 cases of pigment gall stones to examine the role of bacteria in the formation of these stones
Of 84 study subjects, 61 (72.62%) patients presented with biliary colic, and 24(28.57%) patients presented with chronic cholecystitis
Summary
Gall stone disease is known to mankind since ancient times.[1]. Pigment gall stones have been referred to as early as 500 AD by Alexander of Tralle[2 ].These constitute 10% to 27% of all types of gall stones found in general population and both intrahepatic gall stones and stones caused by bile stasis or cirrhosis are usually pigment stones[3]. Enteric bacteria have been found to play a significant role in pigment gall stone formation and these stones in general and brown ones in particular have a tendency to recur while black gall stone disease is usually non recurrent[4]. In this study we prospectively studied 84 cases of pigment gall stones to examine the role of bacteria in the formation of these stones. Methods: A hospital based prospective study of 84 consecutive cases of pigment gall stones was done from December 2012 to November 2019 and the results of stone culture and bile culture were statistically analysed. Conclusion: A strong association was observed between stone culture and bile culture results (showing similar beta-glucronidase producing bacteria) and pigment stone formation.
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