| Theme | Treatment of Choledocholithiasis | |
|---|---|---|
| Title | Pathogenesis of Bile Duct Stone Formation | |
| Publish Date | 2017/01 | |
| Author | Toshihide Ohya | Department of Gastroenterology, Japan Organization of Occupational Health and Safety, Chugoku Rosai Hospital |
| Author | Tomoki Kobayashi | Department of General Medicine, Hiroshima University Hospital |
| Author | Susumu Tazuma | Department of General Medicine, Hiroshima University Hospital |
| [ Summary ] | A nation wide survey regarding stone disease in biliary tract revealed that gallbladder stone, common bile duct stone, and intrahepatic stone were diagnosed in 72 %, 11 %, and 3.6 % of patients, respectively. The origin of common bile duct stone was considered with two reasons, dropping from gallbladder stone or intrahepatic stone and occurring in the common bile duct. There are two theories regarding the pathogenesis of common bile duct. The first, attributes over‒excretion and/or stasis of bilirubin due to hemolytic disease-as the cause of stone formation. The second states that bacterial β-glucuronidase renders bilirubin glucuronide unconjugated and hence insoluble. The insoluble bilirubin is thus nucleated and crystallizes with another component in bile. |
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