Notes on gallbladder stones

The photo below shows multiple faceted gallstones that can be composed of either cholesterol, bile pigments or a mixture of the two.
-Pigment stones are often small and occur in patients with either congenital or acquired haemolytic states (5%).
-Cholesterol stones are often large and solitary (15%).
The stones shown are mixed stones and account for approximately 80% of all gallstones.
"Mixed stones are probably a variant of cholesterol stones"

Pathophysiology:

Cholesterol stones result from a change in solubility of bile constituents

• Bile acids act as a detergent keeping cholesterol in solution
• Bile acids, lecithin and cholesterol result in the formation of micelles
• Bile is often supersaturated with cholesterol
• This favours the formation of cholesterol microcrystals
• Biliary infection, stasis and changes in gallbladder function can precipitate stone formation

 This picture shows a collection of gallstones removed from a gall bladder during a cholecystectomy. Gallstones are more common in females than males. And there prevalence increases with age and diabetes mellitus, obesity, ileal disease and certain drugs (e.g. Clofibrate) appear to be important in the aetiology.
Only 10% of gallstones are symptomatic.Also about 10% of gallstones are radio-opaque and visible on a plain abdominal film.