Abstract
BackgroundTo develop a method for systematic classification of gallbladder stones, analyze the clinical characteristics of each type of stone and provide a theoretical basis for the study of the formation mechanism of different types of gallbladder stones.MethodologyA total of 807 consecutive patients with gallbladder stones were enrolled and their gallstones were studied. The material composition of gallbladder stones was analyzed using Fourier Transform Infrared spectroscopy and the distribution and microstructure of material components was observed with Scanning Electron Microscopy. The composition and distribution of elements were analyzed by an X-ray energy spectrometer. Gallbladder stones were classified accordingly, and then, gender, age, medical history and BMI of patients with each type of stone were analyzed.Principal FindingsGallbladder stones were classified into 8 types and more than ten subtypes, including cholesterol stones (297), pigment stones (217), calcium carbonate stones (139), phosphate stones (12), calcium stearate stones (9), protein stones (3), cystine stones (1) and mixed stones (129). Mixed stones were those stones with two or more than two kinds of material components and the content of each component was similar. A total of 11 subtypes of mixed stones were found in this study. Patients with cholesterol stones were mainly female between the ages of 30 and 50, with higher BMI and shorter medical history than patients with pigment stones (P<0.05), however, patients with pigment, calcium carbonate, phosphate stones were mainly male between the ages of 40 and 60.ConclusionThe systematic classification of gallbladder stones indicates that different types of stones have different characteristics in terms of the microstructure, elemental composition and distribution, providing an important basis for the mechanistic study of gallbladder stones.
Highlights
Cholecystolithiasis is a common disease worldwide [1,2,3,4]
Principal Findings: Gallbladder stones were classified into 8 types and more than ten subtypes, including cholesterol stones (297), pigment stones (217), calcium carbonate stones (139), phosphate stones (12), calcium stearate stones (9), protein stones (3), cystine stones (1) and mixed stones (129)
The systematic classification of gallbladder stones indicates that different types of stones have different characteristics in terms of the microstructure, elemental composition and distribution, providing an important basis for the mechanistic study of gallbladder stones
Summary
Cholecystolithiasis is a common disease worldwide [1,2,3,4]. The incidence of gallstones is 15% in America, 5.9,21.9% in Europe, 4,15% in Asia and 3,11% in China [5,6,7]. Research on the systematic classification of gallbladder stones may help to reveal the formation mechanism of different types of gallstones. The traditional classification scheme classified gallstones into 3 types according to cholesterol content, including cholesterol stone (cholesterol content $70%), pigment stone (cholesterol content #30%) and mixed stone (30% #cholesterol content #70%) [17]. Professor Fu et al (1984) divided gallstones into 8 types according to the profile structure and chemical components These included radial, radial annual ring-like, rock strata-like stromatolite, cast amorphous, sand bed-like stromatolite, silt-like, black, and complex stones [18]. Using FTIR Spectroscopy, Scanning Electron Microscopy and X-ray energy spectrometer and classifying gallstones according to the appearance, profile structure, component content and distribution, microstructure, elemental composition and distribution, the new systematic classification scheme, makes up the deficiency of the traditional classification, and is more accurate. To develop a method for systematic classification of gallbladder stones, analyze the clinical characteristics of each type of stone and provide a theoretical basis for the study of the formation mechanism of different types of gallbladder stones
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