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Gallbladder Pathology Online

Pathology of the Mixed Gallstones 

Dr Sampurna Roy MD


"Mixed" stones constitute the majority (80%) of gallstones found at operation.

1) 2)

        Both 1 and 2 are Mixed stones

Visit: Pigment stones (calcium bilirubinate) ; Cholesterol stone  

Nearly always multiple, they become faceted by mutual pressure or by friction one against the other.

Dozens or hundreds of such stones are often present, frequently the gallbladder being packed to capacity.

On section each is found to be laminated.

The central nucleus may contain epithelial debris and bacteria, which suggests that the cause in that particular case is inflammatory.

Whatever the composition of the central core, alternating layers of cholesterol and calcium carbonate and/or calcium bilirubinate are deposited upon it.


Further reading:

Bile composition in inflammatory bowel disease: ileal disease and colectomy, but not colitis, induce lithogenic bile.

The role of bacteria in gallstone pathogenesis.

Histopathological changes in gallbladder mucosa in cholelithiasis: correlation with chemical composition gallstones.

Composition and immunofluorescence studies of biliary "sludge" in patients with cholesterol or mixed gallstones.

Bacterial DNA in mixed cholesterol gallstones.

The classification of biliary calculi and the clinico-therapeutic implications.

Pathogenesis of biliary sludge.












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