Foreign Material as a Cause of Choledocholithiasis

Introduction

The pathogenesis of gallstone formation in the biliary duct remains unknown. However, numerous factors associated with their origin appear to be of importance. With regard to the formation of concretions in the biliary duct, there are adequate findings concerning the effects of benign or malignant strictures, of bacterial infection and parasites, and of metabolic changes and dietary habits, as well as those of anatomical conditions in the bilioduodenal region [[1] [2] [3] [4] [5] [6]]. However, there are only sporadic reports about foreign material as a cause of lithiasis [[7] [8] [9]].

The aim of the present study was to investigate the structure of gallstones obtained endoscopically from the biliary duct, in order to determine whether foreign material may lead to choledocholithiasis. In addition, the correlation between foreign material in gallstones and clinical data was investigated.

References

• 1 Tabata M, Nakayama F. Bacteria and gallstones: etiological significance.  Dig Dis Sci. 1981;  26 218-24
• 2 Goodhart GL, Levison ME, Trotman BW, et al. Pigment vs. cholesterol cholelithiasis: bacteriology of gallbladder stones, bile and tissue correlation with biliary lipid analysis.  Am J Dig Dis. 1978;  23 877-82
• 3 Lygidakis NJ. Incidence of bile infection in patients with choledocholithiasis.  Am J Gastroenterol. 1982;  77 12-7
• 4 Schulman A. Non-western patterns of biliary stones and the role of ascariasis.  Radiology. 1987;  162 425-30
• 5 Lotveit T, Osnes M, Larsen S. Recurrent biliary calculi: duodenal diverticula as a predisposing factor.  Ann Surg. 1982;  196 30-2
• 6 Kennedy RH, Thompson MH. Are duodenal diverticula associated with choledocholithiasis?.  Gut. 1988;  29 1003-6
• 7 Whiting MJ, Watts JM. Chemical composition of common bile duct stones.  Br J Surg. 1986;  73 229-32
• 8 Wosiewitz U, Schenk J, Sabinski F, et al. Investigations on common bile duct stones.  Digestion. 1983;  26 43-52
• 9 Bergmann M, Borner R, Winnefeld K, et al. Clinical, infrared spectroscopic and chemical analysis of bile duct and gallbladder stones (in German).  Gastroenterol J. 1991;  51 5-11
• 10 Toouli J, Geenen JE, Hogan WJ, et al. Sphincter of Oddi motor activity: a comparison between patients with common bile duct stones and controls.  Gastroenterology. 1982;  82 111-7