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Cholelithiasis in Taiwan

Gallstone characteristics, surgical incidence, bile lipid composition, and role of β-glucuronidase

  • Pancreatic and Biliary Disorders
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Abstract

The nature and occurrence of gallstones in Taiwan and their etiologic factors might not be the same as in Western countries and warranted a systematic investigation. Gallbladder biles and gallstones were obtained at surgery from 100 and 74 patients, respectively. Common duct bile and stones were either drained through an indwelling common duct T-tube or aspirated through a nasobiliary catheter in 108 patients. Gallstones were analyzed for bilirubin, cholesterol, bile acid, calcium, and residue, and biles for bile acid, cholesterol, phospholipid, bilirubin, and β-glucuronidase. There were four major kinds of gallstones in Taiwan: cholesterol/mixed stones, high-residue black formed pigment stones, low-residue brown formed pigment stones, and muddy pigment stones. The surgical incidence of all types of stones increased steadily during the past four decades. During the past 15 years the relative frequencies for mixed, formed pigment, and muddy pigment stones had been roughly 40, 40, and 20%, respectively, with a further increase in the mixed stones and a decrease in the muddy pigment stones in recent years. Improvement of nutritional status and living standards might contribute to such changes. Cholesterol content in the common duct and gallbladder biles was higher in the mixed stone group than in other groups. Bacterial β-glucuronidase activity was detected in 53% of patients with muddy pigment stones. Endogenous β-glucuronidase activity and concentration were also highest in this group, intermediate in the formed pigment and mixed stone group, and lowest in the control. We concluded that hypercholesterobilia was responsible for increasing incidence of mixed stones during the past two decades, while both bacterial and human β-glucuronidase might contribute to pigment cholelithiasis.

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Author notes

  1. Kang-Jey Ho MD, PhD

    Present address: Department of Pathology, University of Alabama at Birmingham and Veterans Affairs Medical Center, 35233, Birmingham, Alabama

Authors and Affiliations

  1. Departments of Laboratory Medicine and Surgery, National Taiwan University, Taipei

    Kang-Jey Ho MD, PhD, Xi-Zhang Lin MD, Sen-Chang Yu MD, Jui-San Chen MD & Chi-Zon WU MS

  2. Department of Medicine, National Cheng-Kung University, Tainan, Taiwan

    Kang-Jey Ho MD, PhD, Xi-Zhang Lin MD, Sen-Chang Yu MD, Jui-San Chen MD & Chi-Zon WU MS

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  1. Kang-Jey Ho MD, PhD
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  2. Xi-Zhang Lin MD
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Additional information

This work was supported in part by Research Grant 820412B002-342 from the National Science Council, Executive Yuen, Republic of China and Medical Research Fund from Department of Veterans Affairs, USA.

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Ho, KJ., Lin, XZ., Yu, SC. et al. Cholelithiasis in Taiwan. Digest Dis Sci 40, 1963–1973 (1995). https://doi.org/10.1007/BF02208665

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  • DOI: https://doi.org/10.1007/BF02208665

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