Clinical background factors for 'black' pigment gallstone formation

Abstract

46 cholecystectomized cases assured as 'black' pigment gallstone by chemical analysis were studied for their determinants of stone formation. Adenomyomatosis (ADM) was accompanied in 32cases (69.9%). 30cases (94%) of them were segmental type of ADM. ADM is thought to be a major determinant for black stone formation. Some of another cases have a history of heart valve replacement, total gasterectomy, chronic hepatitis, duodenal stenosis, and IBS. Those factors have been already reported and discussed. In addition to them, this study showed that gallbladder polyp and a history of operation for appendicitis were identified as independent determinants. Appendectomy may be concerned through enterohepatic cycling. Black stones contained with calcium carbonate would have different factors from pure black stones and calcium phosphate-contained stones.