Abstract
Two hundred and thirty-six gallstones from 227 cases in the Sendai district, taken surgically in Muto's surgical clinic during 1941 and 1958 were analysed chemically with the following conclusion.
1). The kinds of gallstones were as follows ; pure cholesterol stones three, cholesterol-pigment-chalk stones 95, combined stones 17, pigment-chalk stones 104, parasite stones 10 and inorganic stones seven.
Cholesterol stones and pigment stones were approximately the same in number.
2). Gallstones in the gallbladder included cholesterol stones in 56.2 per cent, and were more common than the pigment stones which gave 39.6 per cent. Gallsntoes in the common bile duct included cholesterol stones in 29.9 per cent, and this as far less than the pigment stones which showed 70.1 per cent.
3). The sex distribution was 111 cases in the male and 116 cases in the female showing on equal frequency in both sexes. The ratio of cholesterol stones to pigment stones was 1.0 to 1.18 in the male and 1.31 to 1.0 in the female.
4). Age on admission; In the sixth decade the incidence of cholelithiasis was the highest, then the fifth and the seventh decade followed in frequency. Cholesterol stones were more common than pigment stones in the fourth decade, and pigment stones were more than cholesterol stones in the eighth decade.
5). Distribution according to profession revealed a higher incidence of cholesterol stones in the sedentary group and of pigment stones in the workers group. Cholesterol stones were more common in the city inhabitants group, and pigment stones were more frequent in the farm and fishing village inhabitants group. Also cholesterol stones were seen more frequently in the first and second class patients group, and pigment stones were more common in the third class patients group.
6). Pigment stones had been frequently observed during the period of the poor food condition during the war and post-war time, but with the improvement of the social conditions, cholesterol stones increased gradually, attaining 60 per cent of the total cases in the last two years. The incidence of cholelithiasis itself much increased since 1953 and the tendency to increase still continues at present.
7). From the fact that the higher incidence of cholesterol stones in large cities and that in the Sendai district cholesterol stones increased in number with the recent improvement of food condition, it seems to be reasonable to assume that the characteristic feature of the predominance of pigment stones in Japan is gradually diminishing and the kinds of gallstones resemble that of Europe and the United States.
