Re-confirmation and Re-recongnization of new classification of gallstones in Japan (1986)

Abstract

The new macroscopic classification of gallstones was published by the gallstone classification committee of the Japanese society of gastroenterology on Nihon Shokakibyo Gakkai Zasshi in 1986. Since then the macroscopic classification have been widely spread in Japan, although it has actually several contradictory points. Now, recent paper reported the paper in which they verify the classification compared the stone kinds with the quantity of the components gallstones in JJBA 2017; 31: 205-213. The authors determined three components including cholesterol, calcium bilirubinate and black pigment in gallstone by infrared spectroscopy. They insisted that there is a lot of discrepancy between this classification and infrared analysis especially in black stones. Therefore, they had a negative view on this classification. However, we would like to point out two differences from our standpoint. First, they did not decide the kind of stones according to the rules of the committee. Second, they did not consider a few situations limiting the usefulness of infrared spectroscopic analysis. Particularly each component is unable to be measured quantitatively using infrared spectroscopic analysis. Therefore, the classification of gallstones in Japan (1986) should be re-conform and re-recognize even in 21 century.