Abstract:
BACKGROUND:Bilirubin is the main component of most common bile duct stones. Normally, almost all bilirubin in bile is conjugated to glucuronic acid or some other sugar moiety. These conjugates are unstable and liable to deconjugation. Unconjugated bilirubin is insoluble and may precipitate as the calcium salt found in brown pigment stones. The pattern of bilirubin conjugates in common duct bile of patients with choledocholithiasis has been unknown. METHODS:In a clinical series of 55 patients with choledocholithiasis common-duct bile was aspirated, and the bilirubin conjugates analyzed with high-performance liquid chromatography. One stone from each patient was analyzed for cholesterol and bilirubin content to determine stone type. RESULTS:Sixteen patients had cholesterol stones, 38 patients had brown pigment stones, and 1 patient had a black stone. Patients with pigment stones had a lower percentage of bilirubin diglucuronide (median, 60.3%; interquartile range, 49.7%-67.3%) than patients with cholesterol stones (64.0%; 60.2%-73.3%) (Mann-Whitney, P=0.015). No significant difference was found for the other bilirubin conjugates, total bilirubin, or biliary pH when pigment and cholesterol stone patients were compared. The time of bile sampling in relation to papillotomy and treatment of cholestasis was not associated with the low percentage of bilirubin diglucuronide. The observation of reduced values for bilirubin diglucuronide could not be ascribed to duodenal diverticula or Billroth-II gastric resection. CONCLUSION:The percentage of the main bilirubinate conjugate, bilirubin diglucuronide, is decreased in the common duct bile of patients with pigmented compared with cholesterol stones.
journal_name
Scand J Gastroenteroljournal_title
Scandinavian journal of gastroenterologyauthors
Sandstad O,Osnes T,Urdal P,Skar V,Osnes Mdoi
10.1080/003655200750024399subject
Has Abstractpub_date
2000-02-01 00:00:00pages
198-203issue
2eissn
0036-5521issn
1502-7708journal_volume
35pub_type
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journal_title:Scandinavian journal of gastroenterology
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doi:10.3109/00365528609034652
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journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365529709011201
更新日期:1997-09-01 00:00:00
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更新日期:2006-12-01 00:00:00
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doi:10.3109/00365521.2012.711850
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pub_type: 杂志文章,多中心研究
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journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365529509101613
更新日期:1995-11-01 00:00:00
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journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1080/00365520310003156
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更新日期:1996-04-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Scandinavian journal of gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.3109/00365528809090774
更新日期:1988-09-01 00:00:00
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更新日期:2017-10-01 00:00:00
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doi:10.3109/00365521.2014.990506
更新日期:2015-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1080/00365520902898119
更新日期:2009-01-01 00:00:00
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pub_type: 杂志文章
doi:10.3109/00365521.2015.1027263
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journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.1080/00365521.2018.1464203
更新日期:2018-06-01 00:00:00
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doi:10.3109/00365521.2010.510567
更新日期:2010-12-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2018-05-01 00:00:00
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journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365526709180050
更新日期:1967-01-01 00:00:00
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doi:10.3109/00365521.2012.706826
更新日期:2012-10-01 00:00:00
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pub_type: 杂志文章
doi:10.3109/00365521.2014.899619
更新日期:2014-06-01 00:00:00