Gallstones

Gallstones can occur at any age, but usually occurs after the third decade. Prevalence is 2-5 times higher in women than the men. Gallstones are more common in Scandavia, South America

and Native North Americans.

There are two types of gall stones,

1. Cholesterol stones
2. Pigmented stones

Cholesterol stones

Formed by the crystallization of cholesterol in bile. This depends on,

• Cholesterol supersaturation in bile
• Crystallization promoting factors within bile
• Motility of the gallbladder

Bile pigment stones

Major proportion of the bile pigment stones are composed of calcium bilirubinate and/or calcium phosphate.

Bile pigment stones further categorized depending on the color.

1) Black pigment gall stones

2) Brown pigment gall stones

Black pigment gall stones

Stones range from deep black to very dark brown. Composed of calcium bilirubinate and mucin glycoprotein.

Brown pigment gall stones

Have alternating brown and tan layers. These stones are composed of calcium salts of fatty acids and calcium bilirubinate.

Clinical presentation of Gallstones

80% of the gallstones are asymptomatic.

Some gallstones may cause biliary colic.

It is a pain associated with temporary obstruction of the cystic or common bile duct.

Management of gall bladder stones

Cholecystectomy is the treatment of choice for all patients with gall bladder stones.

But there are some dissolution and shockwave lithotripsy methods available. But these methods are not very effective.