Experimental study of pigment gallstone formation and dissolution
Zhang, W.H.; Zhou, X.S.; Wang, S.S.; Chen, H.H.; Deng, S.Q.; Fu, X.B.
Chinese Medical Journal 100(3): 224-229
1987
ISSN/ISBN: 0366-6999 PMID: 3113846 Document Number: 302688
The bilirubin in the gall stones is identified chemically and by infrared spectroscopy and gel electrophoresis as a polymer in structure. Its precipitation is closely related to the activity of .beta.-glucuronidase, yet it is not the sole factor in conjugated bilirubin hydrolysis resulting in bilirubin precipitation. The quantitative determination of hexoamine with modified Boas-Morgan method shows glycoprotein suggesting that the greater the amount of glycoprotein in the bile, the stronger the lithogenicity. Atomic emission and absorption spectroscopy analysis lead us to believe that any elements appearing in the plasma should also be found in the bile or gallstone. The precipitation of solid substances in bile is strongly influenced by the alteration of Ca++ concentration, therefore the metal ions play an essential role in the formation of so-called insoluble components of the pigment gallstone. Dissolution tests reveal that increase of bile salt or glucuronic acid concentration in the bile can reduce bilirubin precipitation. Chelating agents deprive the metal ions of the stone, leading to breakage and partial dissolution of the stone. CDTA may be a promising drug for dissolution of pigment gallstones.