Determination of gallstone components in 39 patients in ًُُEgyptian hospitals : a study of 300 stones to assess amenability to non-operative treatment

Abstract EN

Objective : The chemical composition of gallstones determines amenability to non-surgical treatment.

It is related to environment, and, to date, this information is not available for patients living in the Middle East.

The purpose of this study was to determine gallstone composition in a group of 39 patients living in Egypt. Methods : Three hundred gallstone samples from patients living in Egypt and treated at Cairo University Teaching Hospital were classified as soft, intermediate, or hard.

Each was cut, polished, preserved, and stored in saline.

Mechanical parameters were studied, and the stones were then analyzed chemically in order to determine cholesterol, calcium and bilirubin content.

Trace metals and elements were determined by particle induced x-ray emission. Results:Thirty five of the 39 patients were females; the mean age was 45.9 years; there was a single stone in 64.1%; and stones were multiple in 35.9%.

Stones were hard in 13 patients and soft in 26, with a mean specific gravity of 0.86 (range 0.69-1.67).

The percentage share for the three major components was cholesterol 70.8 (43- 88), bilirubin 29.5 (10-66), and calcium 2.27 (0.02-7.5).

The mean percentage for other elements was: carbon 76.2, hydrogen 10.49, nitrogen 0.51 and sulphur 1.33.

Trace metals elements were as foll Conclusions:Our patients are good candidates for non-surgical treatment.

In the light of the unique chemical composition of their stones, ESWL is the best.

Oral dissolution requires a long treatment time.

Contact dissolution has no place.

Apart from calcium, the concentration of basic elements and metals is of no value for planning treatment.