Korean J Gastroenterol.  2003 May;41(5):382-390.

Cholesterol Content of Intrahepatic Stones in Korean Patients and its Clinical Significance

• Park YC
• Kim SW
• Jang JY
• Yoon YS
• Ahn YJ
• Park YH

Abstract

BACKGROUNDS/AIMS: Majority of intrahepatic stones found in Korean patients is calcium bilirubinate stone. However, reports defining cholesterol content of intrahepatic stones are rare. This study was conducted to analyze cholesterol content of intrahepatic stone quantitatively and to define its clinical significance. METHODS: Chemical assay and supplementary FTIR (Fourier-transform infrared spectroscope) analysis were performed for cholesterol quantification of intrahepatic stones harvested from 89 consecutive patients by choledochoscope. RESULTS: Intrahepatic stones were grouped by gross appearance and there were 3 cholesterol stones, 2 black stones, and 84 brown stones. Chemical assay disclosed that calcium bilirubinate stones (less than 50% cholesterol) were 89.3% (n=75) of brown stones, and mixed cholesterol stones (50-70% cholesterol) were 10.7% (n=9). Cholesterol content of primary intrahepatic stones (25.9+/-2.5%) were slightly smaller than that of secondary intrahepatic stones (32.8+/-4.1%), but it could not reach statistical significance (p=0.135). There were no significant differences in chemical composition of intrahepatic stones according to clinical findings such as age, sex, body mass index, laboratory findings, and locations of stones. CONCLUSIONS: Intrahepatic stones found in Korean patients have considerably higher cholesterol content than expected by gross inspection. Investigation of the role of cholesterol metabolism in the pathogenesis of intrahepatic stone may be helpful to establish an appropriate strategy of treatment for intrahepatic stone.

Keyword

Cholelithiasis; Hepatolithiasis; Quantitative analysis; Cholesterol