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Microstructural diversity of gallstones revealed by spectral microanalyses and their association with hepatic parameters

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Abstract

Background

Gallstones (GS) are formed as a result of impaired metabolic regulation and can be reflected in serum parameters. This study was focused on classifying GS based on spectral microanalysis and identifying the possible role of serum hepatic parameters on GS of different compositions.

Methods

The study included a total of 126 GS from 80 consecutive patients who underwent cholecystectomy for GS diseases in a single center. The composition and microstructure of GS were analyzed using Fourier-transform infrared (FTIR) spectroscopy, field emission scanning electron microscopy (FESEM), and energy dispersive X-ray spectroscopy (EDS). The serum hepatic parameters were studied in order to establish a possible etiologic relationship with GS composition.

Results

In the study group, the incidence of GS was higher in females 62 (77.5%) compared with males 18 (22.5%). The mean age was 42.81 ± 13.01 and 43.78 ± 14.4 years for female and male patients, respectively. Based on composition, the GS were assigned to four major groups: cholesterol, pigment, phosphate, and mixed stones. Mixed composition stones totally represented the majority 53 (66.3%), followed by pure cholesterol 23 (28.8%), pigment stones 2 (2.5%), and phosphate stones 2 (2.5%), respectively. Elemental composition revealed the presence of carbon (C), oxygen (O), calcium (Ca), and phosphorus (P) to be major elements along with traces of sodium (Na), magnesium (Mg), aluminum (Al), iron (Fe), copper (Cu), bromine (Br), manganese (Mn), and zinc (Zn). Among serum parameters, total bilirubin, direct bilirubin, indirect bilirubin, serum glutamic-oxaloacetic transaminase, and total protein were higher in patients with pigment GS than cholesterol GS.

Conclusions

Characterization of GS indicates that different types of stones have different characteristics in terms of microstructure, elemental composition, and distribution. Serum hepatic function test profiles showed an association with the compositions of GS.

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Author notes

  1. Muhammed A. P. Manzoor and Abhijith S. Sudhakar contributed equally to this work.

Authors and Affiliations

  1. Yenepoya Research Centre, Yenepoya University, Deralakatte, Mangalore, 575 018, India

    Muhammed A. P. Manzoor, Sajida Abdul Kadar & Punchappady-Devasya Rekha

  2. Department of General Surgery, Yenepoya Medical College, Yenepoya University, Deralakatte, Mangalore, 575 018, India

    Abhijith S. Sudhakar & M. S. Moosabba

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  1. Muhammed A. P. Manzoor
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  2. Abhijith S. Sudhakar
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  3. Sajida Abdul Kadar
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Correspondence to Punchappady-Devasya Rekha.

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MAPM, ASS, SAK, MSM, and P-DR declare that they have no conflict of interests.

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S1Fig.

Elemental composition of different types of gallstones derived from Energy-dispersive X-ray spectroscopy. (a). Cholesterol stone. (b). Pigment stone. (c). Cholesterol-phosphate mixed stone. (d). Bilirubinate-calcium carbonate mixed stone. (e). Bilirubinate-phosphate mixed stone. (f). Cholesterol-calcium carbonate mixed stone. (PNG 1183 kb)

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Manzoor, M.A.P., Sudhakar, A.S., Kadar, S.A. et al. Microstructural diversity of gallstones revealed by spectral microanalyses and their association with hepatic parameters. Indian J Gastroenterol 38, 391–398 (2019). https://doi.org/10.1007/s12664-019-00972-5

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