Dissolution of human cholesterol gallstones in vitro with ethanol and ether: a scanning and stereoscanning electron microscopic study
Phillips, M.J.; Funatsu, K.; Oda, M.; Edwards, V.; Mickle, D.A.
Laboratory Investigation; a Journal of Technical Methods and Pathology 39(5): 497-504
1978
ISSN/ISBN: 0023-6837 PMID: 732273 Document Number: 129818
To consider the dissolution of human cholesterol gallstones, the structure of such stones must be studied. Multifaceted cholesterol gallstones from human gallbladders were examined before and during dissolution in vitro, using scanning electron microscopic techniques. Ether and ethanol solutions were used as solvents. The common human cholesterol gallstone has 4 distinct structural zones: outer surface, cortex, inner layer and nidus. Each of these zones has importance in terms of stone formation and dissolution. Dissolution with both agents was similar in that they acted by direct solubilization of cholesterol crystals from the external surfaces. Only after removal of the compact cortical zone was the interior of the stone affected. With ether, the plates undergoing dissolution became thinner, were often curved and appeared readily deformed. Dissolution with ethanol was accompanied by structural changes in the cholesterol plates which differed from those seen with ether. The plates became progressively rounded, blunted, reduced in size and globular. The morphologic findings with ethanol are of particular interest because on the surface of untreated cholesterol gallstones, a variety of crystals with smooth edges or with globular shapes are commonly found. While there is believed to be active cholesterol deposition and dissolution taking place in gallbladder stones, the globular crystals apparently represent active cholesterol deposition. They apparently represent cholesterol crystals undergoing dissolution.