Pigment Gallstones and Secondary Calcification of Gallstones

  • R. D. Soloway
  • J. G. Wu
  • D. F. Xu


For more than a century, biliary tract stones have been broadly identified by their gross characteristics [28]. In fact, this method has been remarkably accurate and has led to the correct classification of more than 90% of stones [29]. However, a number of subclassifications have been proposed which do not take full account of compositional characteristics and thus may not have any pathologic significance. Although subclassification may be important, the classification proposed at the NIH International Gallstone Workshop [30] is compatible with differences in clinical, biochemical, epidemiological, and compositional characteristics of stones that identify three groups with mutually exclusive pathogeneses: cholesterol, black pigment, and brown pigment stones. The accumulated information suggests that although some of the same compounds occur in different types of stones, there are distinguishing compositional differences that allow classification into these three groups in almost all cases. Such a classification clarifies discussion about pathogenesis. For example, the fact that pigmented centers and rings occur in cholesterol stones does not mean that all stones form on a pigment nidus, or the fact that both black and brown pigment stones contain calcium bilirubinate does not mean that the pathogenesis of these stone types is the same.


Primary Sclerosing Cholangitis Cholesterol Gallstone Calcium Salt Neutral Salt Calcium Hydroxyapatite 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag, Berlin Heidelberg 1990

Authors and Affiliations

  • R. D. Soloway
    • 1
  • J. G. Wu
    • 2
  • D. F. Xu
    • 3
  1. 1.Division of GastroenterologyUniversity of Texas Medical Branch at GalvestonGalvestonUSA
  2. 2.Department of ChemistryBeijing UniversityBeijingPeople’s Republic of China
  3. 3.Section of Polymer ChemistrySinica AcademicaBeijingPeople’s Republic of China

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