Why do black pigment stones cause gallbladder contractility function disorder?

May 14, 2008

Chemically, black pigment stones is the polymerized bilirubin with metals. Therefore, environments suitable for the formation of black pigment stones are conditions that allow chemical polymerization with sufficient time. However, there have been very few reports describing the gallbladder motility with special reference to the pathogenesis of black pigment stones formation to date.

A research article to be published on May 14, 2008 in the World Journal of Gastroenterology addresses this question. The research led by Professor, Hakamada from Department of Surgery, Hirosaki University, analyzed physiological patterns of bile evacuation from the gallbladder quantitatively by cholescintigraphy.

In this article, the authors observed significantly shorter ejection periods and ejection fractions in 14 patients with black pigment stones in comparison to those in 22 cholesterol stone patients and 28 normal subjects. Consequently, ejection rate of the gallbladder emptying was found significantly smaller in patients with black pigment stones, they reported.

Over the past century, many studies have been conducted to disclose a close association with gallbladder dysmotility and gallstone diseases. Previous studies, however, have yielded conflicting results. In the view of the authors, these conflicting results derived in part from different methodology to assess gallbladder motility, and also from the facts that these studies were conducted without taking into account the chemical characteristics of their stones.

By using a less invasive method of computer cholescintigraphy and selecting patients according to their backgrounds strictly, they concluded that bile stagnation due to impaired gallbladder kinetics seems one of the predisposing factors for the development of black pigment stones.

These results demonstrate a new view of disease mechanism of this old common disease, and thus may progress the understanding the relation between physiological aspects and the epidemiology of the gallstone diseases.

World Journal of Gastroenterology

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