Gallensteine und Gallensteinleiden

  • U. Leuschner


Man unterscheidet 3 Steintypen: den Cholesterinstein, den schwarzen Pigmentstein und den braunen Pigmentstein, auch Kalziumbilirubinatstein genannt. Gemischte Steine enthalten die einzelnen Komponenten in unterschiedlichen Konzentrationen. Ein seltener, nur in Japan beschriebener Stein, ist der sog. Pfefferund- Salz-Stein.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Behar J, Lee KY, Thompson WR, Biancani P (1989) Gallbladder contraction in patients with pigment and cholesterol stones. Gastroenterology 97: 1479–1484PubMedGoogle Scholar
  2. Carey MC, LaMont JT (1992) Cholesterol gallstone formation. 1. Physical chemistry of bile and biliary lipid secretion. Progr Liver Dis 10: 139–163PubMedGoogle Scholar
  3. Collet D (1997) Laparoscopic cholecystectomy in 1994. Results of a prospective survey conducted by SFCERO on 4624 cases. Surg Endosc 11: 56–63PubMedCrossRefGoogle Scholar
  4. Cotton BP (1986) Two to nine year follow up after sphincterotomy for stones in patients with gallbladders. Gastrointest Endosc 32: 157–158Google Scholar
  5. Cotton BP, Kozarek RA, Schapiro RH et al. (1990) Endoscopic laser lithotripsy of large bile duct stones. Gastroenterology 99: 1128–1133PubMedGoogle Scholar
  6. Crowther RS, Soloway RD (1990) Pigment gallstone pathogenesis: from man to molecules. Semin Liver Dis 3: 17l–180Google Scholar
  7. Deziel DJ (1994) Complications of cholecystectomy. Incidence, clinical manifestations, and diagnosis. Surg Clin North Am 74:809–823Google Scholar
  8. Ell C, Schneider HT, Benninger J et al. (1992) Significance of computed tomography for shock-wave therapy of radiolucent gallbladder stones. Gastroenterology 101: 1409–1416Google Scholar
  9. Giovannucci E, Colditz GA, Stampfer MJ (1993) A meta-analysis of cholecystectomy and risk of colorectal cancer. Gastroenterology 105: 130–141PubMedGoogle Scholar
  10. Goldbohm RA, van den Brandt PA, Van’T Veer P et al. (1993) Cholecystectomy and colorectal cancer: evidence from a cohort study on diet and cancer. Int J Cancer 53: 735–738PubMedCrossRefGoogle Scholar
  11. Gracie W, Ransohoff D (1982) The natural history of silent gallstones. The innocent gallstone is not a myth. N Engl J Med 307:798–800CrossRefGoogle Scholar
  12. Griffith DP, Gleeson MJ (1990) Gallstones: advantages and disadvantages in five treatment alternatives. J Lithotripsy Stone Dis 2: 184–198Google Scholar
  13. Kaminski DL, Feinstein WK, Desphande YG (1994) The production of experimental cholecystitis by endotoxin. Prostaglandins 47: 233–235PubMedCrossRefGoogle Scholar
  14. Hellstern A, Leuschner U, Benjaminov A et al. (1998) Dissolution of gallbladder stones with methyl tert-butyl ether and stone recurrence: a European survey. Dig Dis Sci 43: 911–920PubMedCrossRefGoogle Scholar
  15. Lai ECS, Mok EPT, Tan ESY et al. (1992) Endoscopic biliary drainage for severe acute cholangitis. N Engl J Med 326: 1582–1586PubMedCrossRefGoogle Scholar
  16. Leuschner U (1994) Contact dissolution. Eur J Gastroenterol Hepatol 6: 873–879CrossRefGoogle Scholar
  17. Leuschner M, Leuschner U, Strohm WD et al. (1984) Radiological and ultrasonographic investigations with respect to patient selection and monitoring for chemical gallstone dissolution. Hepatogastroenterology 31: 140–143PubMedGoogle Scholar
  18. Leuschner U, Güldütuna S, Hellstern A (1991) Etiology, pathogenesis and therapy of pigment gallstones. Dig Dis 9: 282–293PubMedCrossRefGoogle Scholar
  19. Leuschner U, Hellstern A, Güldütuna S et al. (1991) Direct contact dissolution of gallbladder stones with methyl tert-butyl ether: experience in 209 patients. Ergebn Gastroenterol Verh 26: 199–201Google Scholar
  20. Leuschner U, Seifert E, Winkeltau G et al. (Hrsg) (1995) Gallenwegserkrankungen. Wissenschaftliche Verlagsgesellschaft, StuttgartGoogle Scholar
  21. Lowenfels AB, Walter AM, Althans DP et al. (1989) Gallstone growth, size and risk of gallbladder cancer: an interracial study. Int J Epidem 18: 50–57CrossRefGoogle Scholar
  22. Neoptolemus JP, Shaw DE, Carr-Locke DL (1989) A multi variate analysis of preoperative risk factors in patients with common bile duct stones — implications for treatment. Ann Surg 209: 157–161CrossRefGoogle Scholar
  23. Pereira SP, Veysey MJ, Kennedy C et al. (1997) Gallstone dissolution with oral bile acid therapy. Importance of pretreatment CT scanning and reasons for nonresponse. Dig Dis Sci 42: 1775–1782PubMedCrossRefGoogle Scholar
  24. Petroni ML, Jazrawi RP, Lanzini A et al. (1996) Repeated bile acid therapy for the long-term management of cholesterol gallstones. J Hepatol 25: 7l9–724CrossRefGoogle Scholar
  25. Riemann JF, Demling L (1983) Lithotripsy of bile duct stones. Endoscopy 15: 191–196PubMedCrossRefGoogle Scholar
  26. Ros E, Valderrama R, Bru C et al. (1994) Symptomatic versus silent gallstones. Radiographic features and eligibility for nonsurgical treatment. Dig Dis Sci 39: 1697–1703PubMedCrossRefGoogle Scholar
  27. Ros E, Zambón D (1987) Postcholecystectomy symptoms. A prospective study of gallstone patients before and two years after surgery. Gut 28: 1500–1504PubMedCrossRefGoogle Scholar
  28. Roslyn JJ, Binns GS, Huges EFX et al. (1993) Open cholecystectomy: a contemporary analysis of 42472 patients. Ann Surg 218: 129–137PubMedCrossRefGoogle Scholar
  29. Sackmann M, Pauletzki J, Sauerbruch T (1991) The Munich gallbladder lithotripsy study. Results of the first 5 years with 711 patients. Ann Intern Med 114: 290–296PubMedGoogle Scholar
  30. Sarna C, Labate AMM, Taroni F et al. (1990) Epidemiology and natural history of gallstone disease. Semin Liver Dis 3: 149–158Google Scholar
  31. Sauter G, Ruckdeschel G, Sauerbruch T (1992) Antibiotische Prophylaxe und Therapie infektiöser Komplikationen. Z Gastroenterol 30: 705–708Google Scholar
  32. Schwesinger WH, Diehl AK (1996) Changing indications for laparoscopic cholecystectomy. Surg Clin North Am 76: 493–504PubMedCrossRefGoogle Scholar
  33. Seifert E, Schulte F, Chalybäus C (1989) Quo vadis endoskopische Sphinkterotomie? Z Gastroenterol 27: 77–82PubMedGoogle Scholar
  34. Staritz M, Poralla T, Dormeyer H-H et al. (1985) Endoscopic removal of common duct stones through the intact papilla after medical sphincter dilatation. Gastroenterology 88: 1807–1811PubMedGoogle Scholar
  35. Thistle JL, May GR, Bender CE et al. (1989) Dissolution of cholesterol gallbladder stones by methyl tert-butyl ether administered by percutaneous transhepatic catheter. N Engl J Med 320: 633–639PubMedCrossRefGoogle Scholar
  36. Villanova N, Bazzoli F, Taroni F et al. (1989) Gallstone recurrence after successful oral bile acid treatment. A 12-year follow-up study and evaluation of long-term postdissolution treatment. Gastroenterology 97: 726–731PubMedGoogle Scholar
  37. Warren BL (1992) Small vessel occlusion in acute acalculous cholecystitis. Surgery 111: 163–165PubMedGoogle Scholar
  38. Wolpers C, Hofmann AF (1993) Solitary versus multiple cholesterol gallstones. Mechanisms of formation and growth. J Clin Invest 71: 423–434Google Scholar
  39. Zuin M, Petroni ML, Grandinetti G et al. (1991) Comparison of effects of chenodeoxycholic and ursodeoxycholic acid and their combination on biliary lipids in obese patients with gallstones. Scand J Gastroenterol 26: 257–262PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • U. Leuschner

There are no affiliations available

Personalised recommendations