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Differentiation of gallbladder stones according to their external structure and cross-sectional morphological features such as color, size and shape

Year 2025, Volume: 4 Issue: 1, 24 - 31, 27.06.2025
https://doi.org/10.5281/zenodo.15739462

Abstract

Gallstones are gravel-like substances that form over time inside the gallbladder and are one of the most painful biliary tract diseases in adults and are known to have a high incidence. Bile is composed of water, cholesterol, fats, bile salts, proteins and bilirubin. While bile can usually dissolve cholesterol, crystals that can eventually turn into stones can form in the presence of too much cholesterol. In some cases, an increase in bilirubin levels can cause stone formation. The process of gallstone formation can be listed as: hard chemical particles that form and develop inside the gallbladder after a complex series of events such as bile supersaturation, nucleation, stone accumulation and stone growth. Each gallstone has its own causes and formation mechanisms. The factors that affect the composition of gallstones can be classified as: age, diet, geographic region, obesity, weight loss and ethnicity. It is difficult to define a clear classification system according to the types of an ideal gallstone, but we can generally group them according to their main chemical composition. Key factors in the etiopathogenesis of gallstone disease can be determined by chemical, structural and elemental composition analyses. Different complementary analytical techniques, both microscopic and spectroscopic, can be applied and the ultrastructure of gallstones and the identification of trace elements can also be done. The aim of this study was to investigate the structural features of gallstones in sixty patients accepted for cholecystectomy from Erzincan and surrounding regions. In addition, when the structure of the stones was examined, concentric layers containing alternating dark and light colored bands were observed, emphasizing the importance of compositional changes in bile during the formation of gallstones.

References

  • Carey MC. Pathogenesis of gallstones. Recenti Prog Med. 1992 Jul-Aug;83(7-8):379-91. PMID: 1529152.
  • Costa CJ, Nguyen MTT, Vaziri H, Wu GY. Genetics of Gallstone Disease and Their Clinical Significance: A Narrative Review. J Clin Transl Hepatol. 2024;12(3):316-326. doi: 10.14218/JCTH.2023.00563.
  • Di Ciaula A. and Portincasa P. Recent advances in understanding and managing cholesterol gallstones [version 1; peer review: 2 approved]. F1000Research 2018, 7(F1000 Faculty Rev):1529 (https://doi.org/10.12688/f1000research.15505.1)
  • Gu Q, Zhou G, Xu T, et al. Risk factors for gallstone disease in Shanghai: an observational study. Medicine. 2020;99(3):e18754.
  • Ha BJ, Park S. Classification of gallstones using Fourier-transform infrared spectroscopy and photography. Biomater Res. 2018 Jul 18;22:18. doi: 10.1186/s40824-018-0128-8. PMID: 30038795; PMCID: PMC6052647.
  • Internal Clinical Guidelines T . National Institute for Health and Care Excellence: Clinical Guidelines. Gallstone Disease: Diagnosis and Management of Cholelithiasis, Choledocholithiasis and Choledocholithiasis. London: National Institute for Health and Care Excellence (UK) Copyright (c) National Clinical Guideline Centre, 2014;2014.
  • Jayasoma K, Koralegedara NH, Dharmapala A, Chandrajith R. Microstructural and Geochemical Characterization of Gallstones: Implication for Biomineralization. Biol Trace Elem Res. 2022 Dec;200(12):4891-4902. doi: 10.1007/s12011-021-03076-4. Epub 2022 Jan 28. PMID: 35089502.
  • Jones MW, Weir CB, Ghassemzadeh S. Gallstones (Cholelithiasis) [Updated 2024 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.
  • Jukić T, Margetić BA, Jakšić N, Boričević V. Personality differences in patients with and without gallstones. J Psychosom Res. 2023 Jun;169:111322. doi: 10.1016/j.jpsychores.2023.111322. Epub 2023 Mar 27. PMID: 37018955.
  • Kim IS, Myung SJ, Lee SS, Lee SK, Kim MH. Classification and nomenclature of gallstones revisited. Yonsei Med J. 2003 Aug 30;44(4):561-70. doi: 10.3349/ymj.2003.44.4.561. PMID: 12950109.
  • Lammert F, Gurusamy K, Ko CW, Miquel JF, Méndez-Sánchez N, Portincasa P, van Erpecum KJ, van Laarhoven CJ, Wang DQ. Gallstones. Nat Rev Dis Primers. 2016 Apr 28;2:16024. doi: 10.1038/nrdp.2016.24. PMID: 27121416.
  • Lee BJH, Yap QV, Low JK, Chan YH, Shelat VG. Cholecystectomy for asymptomatic gallstones: Markov decision tree analysis. World J Clin Cases. 2022 Oct 16;10(29):10399-10412. doi: 10.12998/wjcc.v10.i29.10399. PMID: 36312509; PMCID: PMC9602237.
  • Liu JS, Huang CS, Lien HH. Structural analysis of gallstones with thin-section petrographic microscopy: a study of 100 gallstones from Taiwanese patients. J Lab Clin Med. 2002 Dec;140(6):387-90. doi: 10.1067/mlc.2002.129309. PMID: 12486405.
  • Liu, J.-X., Liu, Y., & Shen, Q.-H. Study on the correlation of electron spin resonance with pigment gallstones and trace Cu2+, Fe3+ in diet. 2025 Scientific Reports, 15(1). https://doi.org/10.1038/s41598-025-93870-0.
  • Nakeeb A, Comuzzie AG, Martin L, Sonnenberg GE, Swartz-Basile D, Kissebah AH, Pitt HA. Gallstones: genetics versus environment. Ann Surg. 2002 Jun;235(6):842-9. doi: 10.1097/00000658-200206000-00012. PMID: 12035041; PMCID: PMC1422514.
  • Pak M, Lindseth G. Risk Factors for Cholelithiasis. Gastroenterol Nurs. 2016 Jul-Aug;39(4):297-309. doi: 10.1097/SGA.0000000000000235. PMID: 27467059; PMCID: PMC8802735.
  • Parra-Landazury NM, Cordova-Gallardo J, Méndez-Sánchez N. Obesity and Gallstones. Visc Med. 2021 Oct;37(5):394-402. doi: 10.1159/000515545. Epub 2021 Apr 23. PMID: 34722722; PMCID: PMC8543292.
  • Portincasa, P., Moschetta, A. & Palasciano, G. Cholesterol gallstone disease. Lancet 368, 230–239 (2006).
  • Peter A, Cozmuta LM, Nicula C, Cozmuța AM, Vulpoi A, Barbu-Tudoran L, Magyari K, Todea M, Baia L, Pop FG. Multi-analyses of gallstones and correlation between their properties with the laboratory results. Anal Biochem. 2020 Mar 15;593:113587. doi: 10.1016/j.ab.2020.113587. Epub 2020 Jan 21. PMID: 31978457.
  • Sebghatollahi V, Parsa M, Minakari M, Azadbakht S. A clinician's guide to gallstones and common bile duct (CBD): A study protocol for a systematic review and evidence-based recommendations. Health Sci Rep. 2023 Sep 12;6(9):e1555. doi: 10.1002/hsr2.1555.
  • Shaffer EA. Gallstone disease: Epidemiology of gallbladder stone disease. Best Pract Res Clin Gastroenterol. 2006;20(6):981-96. doi: 10.1016/j.bpg.2006.05.004. PMID: 17127183.
  • Singh VK, Jaswal BS, Sharma J, Rai PK. Analysis of stones formed in the human gall bladder and kidney using advanced spectroscopic techniques. Biophys Rev. 2020 Jun;12(3):647-668. doi: 10.1007/s12551-020-00697-2. Epub 2020 May 14. PMID: 32410185; PMCID: PMC7311631.
  • Stinton LM, , Shaffer EA. Epidemiology of Gallbladder Disease: Cholelithiasis and Cancer. Gut and Liver 2012;6:172-187.
  • Tazuma S. Gallstone disease: Epidemiology, pathogenesis, and classification of biliary stones (common bile duct and intrahepatic). Best Pract Res Clin Gastroenterol. 2006;20(6):1075-83. doi: 10.1016/j.bpg.2006.05.009. PMID: 17127189.
  • Trotman BW. Pigment gallstone disease. Gastroenterol Clin North Am. 1991 Mar;20(1):111-26. PMID: 2022417.

Differentiation of gallbladder stones according to their external structure and cross-sectional morphological features such as color, size and shape

Year 2025, Volume: 4 Issue: 1, 24 - 31, 27.06.2025
https://doi.org/10.5281/zenodo.15739462

Abstract

Gallstones are gravel-like substances that form over time inside the gallbladder and are one of the most painful biliary tract diseases in adults and are known to have a high incidence. Bile is composed of water, cholesterol, fats, bile salts, proteins and bilirubin. While bile can usually dissolve cholesterol, crystals that can eventually turn into stones can form in the presence of too much cholesterol. In some cases, an increase in bilirubin levels can cause stone formation. The process of gallstone formation can be listed as: hard chemical particles that form and develop inside the gallbladder after a complex series of events such as bile supersaturation, nucleation, stone accumulation and stone growth. Each gallstone has its own causes and formation mechanisms. The factors that affect the composition of gallstones can be classified as: age, diet, geographic region, obesity, weight loss and ethnicity. It is difficult to define a clear classification system according to the types of an ideal gallstone, but we can generally group them according to their main chemical composition. Key factors in the etiopathogenesis of gallstone disease can be determined by chemical, structural and elemental composition analyses. Different complementary analytical techniques, both microscopic and spectroscopic, can be applied and the ultrastructure of gallstones and the identification of trace elements can also be done. The aim of this study was to investigate the structural features of gallstones in sixty patients accepted for cholecystectomy from Erzincan and surrounding regions. In addition, when the structure of the stones was examined, concentric layers containing alternating dark and light colored bands were observed, emphasizing the importance of compositional changes in bile during the formation of gallstones.

Ethical Statement

This study was approved by the Erzincan Binali Yıldırım University Clinical Research Ethics Committee meeting dated 09/01/2025, with the decision numbered 2025-01/03.

References

  • Carey MC. Pathogenesis of gallstones. Recenti Prog Med. 1992 Jul-Aug;83(7-8):379-91. PMID: 1529152.
  • Costa CJ, Nguyen MTT, Vaziri H, Wu GY. Genetics of Gallstone Disease and Their Clinical Significance: A Narrative Review. J Clin Transl Hepatol. 2024;12(3):316-326. doi: 10.14218/JCTH.2023.00563.
  • Di Ciaula A. and Portincasa P. Recent advances in understanding and managing cholesterol gallstones [version 1; peer review: 2 approved]. F1000Research 2018, 7(F1000 Faculty Rev):1529 (https://doi.org/10.12688/f1000research.15505.1)
  • Gu Q, Zhou G, Xu T, et al. Risk factors for gallstone disease in Shanghai: an observational study. Medicine. 2020;99(3):e18754.
  • Ha BJ, Park S. Classification of gallstones using Fourier-transform infrared spectroscopy and photography. Biomater Res. 2018 Jul 18;22:18. doi: 10.1186/s40824-018-0128-8. PMID: 30038795; PMCID: PMC6052647.
  • Internal Clinical Guidelines T . National Institute for Health and Care Excellence: Clinical Guidelines. Gallstone Disease: Diagnosis and Management of Cholelithiasis, Choledocholithiasis and Choledocholithiasis. London: National Institute for Health and Care Excellence (UK) Copyright (c) National Clinical Guideline Centre, 2014;2014.
  • Jayasoma K, Koralegedara NH, Dharmapala A, Chandrajith R. Microstructural and Geochemical Characterization of Gallstones: Implication for Biomineralization. Biol Trace Elem Res. 2022 Dec;200(12):4891-4902. doi: 10.1007/s12011-021-03076-4. Epub 2022 Jan 28. PMID: 35089502.
  • Jones MW, Weir CB, Ghassemzadeh S. Gallstones (Cholelithiasis) [Updated 2024 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.
  • Jukić T, Margetić BA, Jakšić N, Boričević V. Personality differences in patients with and without gallstones. J Psychosom Res. 2023 Jun;169:111322. doi: 10.1016/j.jpsychores.2023.111322. Epub 2023 Mar 27. PMID: 37018955.
  • Kim IS, Myung SJ, Lee SS, Lee SK, Kim MH. Classification and nomenclature of gallstones revisited. Yonsei Med J. 2003 Aug 30;44(4):561-70. doi: 10.3349/ymj.2003.44.4.561. PMID: 12950109.
  • Lammert F, Gurusamy K, Ko CW, Miquel JF, Méndez-Sánchez N, Portincasa P, van Erpecum KJ, van Laarhoven CJ, Wang DQ. Gallstones. Nat Rev Dis Primers. 2016 Apr 28;2:16024. doi: 10.1038/nrdp.2016.24. PMID: 27121416.
  • Lee BJH, Yap QV, Low JK, Chan YH, Shelat VG. Cholecystectomy for asymptomatic gallstones: Markov decision tree analysis. World J Clin Cases. 2022 Oct 16;10(29):10399-10412. doi: 10.12998/wjcc.v10.i29.10399. PMID: 36312509; PMCID: PMC9602237.
  • Liu JS, Huang CS, Lien HH. Structural analysis of gallstones with thin-section petrographic microscopy: a study of 100 gallstones from Taiwanese patients. J Lab Clin Med. 2002 Dec;140(6):387-90. doi: 10.1067/mlc.2002.129309. PMID: 12486405.
  • Liu, J.-X., Liu, Y., & Shen, Q.-H. Study on the correlation of electron spin resonance with pigment gallstones and trace Cu2+, Fe3+ in diet. 2025 Scientific Reports, 15(1). https://doi.org/10.1038/s41598-025-93870-0.
  • Nakeeb A, Comuzzie AG, Martin L, Sonnenberg GE, Swartz-Basile D, Kissebah AH, Pitt HA. Gallstones: genetics versus environment. Ann Surg. 2002 Jun;235(6):842-9. doi: 10.1097/00000658-200206000-00012. PMID: 12035041; PMCID: PMC1422514.
  • Pak M, Lindseth G. Risk Factors for Cholelithiasis. Gastroenterol Nurs. 2016 Jul-Aug;39(4):297-309. doi: 10.1097/SGA.0000000000000235. PMID: 27467059; PMCID: PMC8802735.
  • Parra-Landazury NM, Cordova-Gallardo J, Méndez-Sánchez N. Obesity and Gallstones. Visc Med. 2021 Oct;37(5):394-402. doi: 10.1159/000515545. Epub 2021 Apr 23. PMID: 34722722; PMCID: PMC8543292.
  • Portincasa, P., Moschetta, A. & Palasciano, G. Cholesterol gallstone disease. Lancet 368, 230–239 (2006).
  • Peter A, Cozmuta LM, Nicula C, Cozmuța AM, Vulpoi A, Barbu-Tudoran L, Magyari K, Todea M, Baia L, Pop FG. Multi-analyses of gallstones and correlation between their properties with the laboratory results. Anal Biochem. 2020 Mar 15;593:113587. doi: 10.1016/j.ab.2020.113587. Epub 2020 Jan 21. PMID: 31978457.
  • Sebghatollahi V, Parsa M, Minakari M, Azadbakht S. A clinician's guide to gallstones and common bile duct (CBD): A study protocol for a systematic review and evidence-based recommendations. Health Sci Rep. 2023 Sep 12;6(9):e1555. doi: 10.1002/hsr2.1555.
  • Shaffer EA. Gallstone disease: Epidemiology of gallbladder stone disease. Best Pract Res Clin Gastroenterol. 2006;20(6):981-96. doi: 10.1016/j.bpg.2006.05.004. PMID: 17127183.
  • Singh VK, Jaswal BS, Sharma J, Rai PK. Analysis of stones formed in the human gall bladder and kidney using advanced spectroscopic techniques. Biophys Rev. 2020 Jun;12(3):647-668. doi: 10.1007/s12551-020-00697-2. Epub 2020 May 14. PMID: 32410185; PMCID: PMC7311631.
  • Stinton LM, , Shaffer EA. Epidemiology of Gallbladder Disease: Cholelithiasis and Cancer. Gut and Liver 2012;6:172-187.
  • Tazuma S. Gallstone disease: Epidemiology, pathogenesis, and classification of biliary stones (common bile duct and intrahepatic). Best Pract Res Clin Gastroenterol. 2006;20(6):1075-83. doi: 10.1016/j.bpg.2006.05.009. PMID: 17127189.
  • Trotman BW. Pigment gallstone disease. Gastroenterol Clin North Am. 1991 Mar;20(1):111-26. PMID: 2022417.
There are 25 citations in total.

Details

Primary Language English
Subjects Atomic, Molecular and Optical Physics (Other)
Journal Section Research Articles
Authors

Orhan Çimen

Ferda Keskin Çimen

Sevil Porikli Durdağı

Hatice Gedik This is me

Early Pub Date June 25, 2025
Publication Date June 27, 2025
Submission Date April 30, 2025
Acceptance Date June 19, 2025
Published in Issue Year 2025 Volume: 4 Issue: 1

Cite

APA Çimen, O., Keskin Çimen, F., Porikli Durdağı, S., Gedik, H. (2025). Differentiation of gallbladder stones according to their external structure and cross-sectional morphological features such as color, size and shape. Journal of Anatolian Physics and Astronomy, 4(1), 24-31. https://doi.org/10.5281/zenodo.15739462