ABC of diseases of liver, pancreas, and biliary system: Gallstone disease

doi:10.1136/bmj.322.7278.91

BMJ 2001;322:91-94 ( 13 January )

Clinical review

ABC of diseases of liver, pancreas, and biliary system

Gallstone disease

I J Beckingham.

The first 150 words of the full text of this article appear below.

Gall stones are the most common abdominal reason for admission to hospital in developed countries and account for an importantpart of healthcare expenditure. Around 5.5 million people havegall stones in the United Kingdom, and over 50 000 cholecystectomiesare performed each year.

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Types of gall stone and aetiology

Normal bile consists of 70% bile salts (mainly cholic and chenodeoxycholic acids), 22% phospholipids (lecithin), 4% cholesterol,3% proteins, and 0.3% bilirubin. Cholesterol or cholesterol predominant(mixed) stones account for 80% of all gall stones in the UnitedKingdom and form when there is supersaturation of bile with cholesterol.Formation of stones is further aided by decreased gallbladdermotility. Black pigment stones consist of 70% calcium bilirubinateand are more common in patients with haemolytic diseases (sicklecell anaemia, hereditary spherocytosis, thalassaemia) and cirrhosis.

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Brown pigment stones are uncommon in Britain (accounting for <5% of stones) and are formed within the intraheptic and extrahepaticbile ducts as well . . . [Full text of this article]

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