A STUDY OF CHOLESTEROL GALLSTONE FORMATION IN CASES OF CHOLESTEROLOSIS OF THE GALLBLADDER

Abstract

Chemical and morphological analysis of gallbladder mucosa, gallbladder bile andgallstones, obtained by surgical resection from 27 patients with cholesterolosis of the gallbladder, were performed in order to clarify the mechanism of cholesterol gallstone formation.
The chemical analysis indicated that the foamy cells, which were present in the gallbladder mucosa with cholesterolosis, consisted chiefly of cholesterol oleate and palmitate.Both cholesterol gallstones and radial cholesterol crystals were found together with the foamy cells in the mucosa of cholesterolosis. The analysis of the granules which were present on the surface of the mucosa revealed that the cholesterol composition was the same as that of the foamy cells, which were also present in the gallbladder bile and on the stones.
It is therefore suggested that gallstone formation in cases of cholesterolosis progresses in the following order: first of all, intramucosal foamy cells (polypous cholesterolosis) appear; granules are discharged onto the mucosal surface and then into the gallbladder bile; following that, cholesterol cyrstals, irregularly shaped soft solids and finally the gallstone itself are formed.