The Chemistry of Gallstones: Linking Chemical Composition to Gross Morphology and Treatment Modality in a Southern Iranian Population

Abstract

Background:

The management of gallstone disease necessitates a thorough understanding of the various stone types and their chemical composition. While studies on gallstones have been conducted worldwide, no research has been performed in southern Iran.

Materials and Methods:

This cross-sectional study analyzed 164 cholecystectomy specimens from patients with symptomatic gallstones over a 6-month period. Demographic data, stone type, histological diagnosis, and chemical composition of blood and stones—including cholesterol, calcium, phosphate, and bilirubin—were examined using an autoanalyzer and manual methods.

Results:

Most patients (78.7%) were female, 21.3% were male, and the average age was above 40 years. Mixed stones were the most common type (52.4%), followed by cholesterol and pigment stones. All stone types were more prevalent in women. Patients over 40 were more likely to have mixed and pigment stones, whereas younger patients had a higher incidence of cholesterol stones. Chronic cholecystitis was the most frequent histological finding (86%), followed by acute cholecystitis. One case demonstrated carcinoma in situ. Cholesterol concentration was highest in cholesterol stones (P<0.0001), whereas calcium and bilirubin levels were highest in pigment stones (P<0.0001). Only bilirubin levels showed a significant correlation with stone type in blood analysis.

Conclusion:

Different geographical regions, as well as various areas within a country, experience distinct types of gallstones. Accurate classification of gallstones is essential for optimal gallstone treatment, highlighting the importance of designing such research in every region.