Quantitative analysis of gallstones in Libyan patients

Pre- and Post-operative Comparative Analysis of Serum Lipid Profile in Patients with Cholelithiasis

BACKGROUND

Gallstones have become a major health problem because of their silent manifestation and unclear pathogenesis. Although the association between the disturbed lipid metabolism and formation of gallstones has been elucidated in many studies, the effect of cholecystectomy on lipid profile has not been studied in detail.

AIM

The aim of the present study was to study the effect of cholecystectomy on lipid levels in patients with gallstones.

MATERIALS AND METHODS

The study was conducted on 50 patients with gallstones and 30 healthy volunteers for comparison of lipid levels. Subsequently, cholecystectomy was conducted on patients with gallstones and pre- and post-operative lipid levels were compared.

RESULTS

There was a significant decrease in total cholesterol, and triglycerides levels and increase in high-density lipoprotein levels after 1 month of surgery, while low-density lipoprotein levels and very low-density lipoprotein were not statistically changed.

CONCLUSION

Cholecystectomy can significantly improve lipid levels in patients with gallstones.

New Evidences of Key Factors Involved in "Silent Stones" Etiopathogenesis and Trace Elements: Microscopic, Spectroscopic, and Biochemical Approach

The knowledge of the key factors involved in etiopathogenesis of the gallstone disease requires chemical, structural, and elemental composition analysis. The application of different complementary analytical techniques, both microscopic and spectroscopic, are aimed to provide a more comprehensive determination of the gallbladder calculi ultrastructure and trace element identification. High sensitivity techniques such as electron microscopy (SEM), Fourier transform infrared (FTIR), electron paramagnetic resonance (EPR) spectroscopy, and X-ray diffraction (XRD) along with biochemical analysis are used in a new attempt to investigate various factors which play a regulatory role in the pathogenesis of gallstones. The microstructure of different types of gallbladder stones has specific characteristics which are related to the elemental composition. The binding of metal ions with bile salts and bilirubin plays important roles in gallstone formation as revealed by FTIR spectrum of calcium bilirubinate complex in pigment gallstones. The EPR results demonstrated the generation of bilirubin free radicals and variation of its electronic structure and conjugation system in the skeleton of bilirubin molecule during complex formation. EPR spectra of pigment gallstones demonstrate the coexistence of four paramagnetic centers including stable bilirubin free radical, Mn2+, Cu2+, and Fe3+ with distinct magnetic parameters and well-resolved hyperfine structure in the case of Mn2+ ions. The result confirms a macromolecular network structure with proteins and the formation of bilirubin-coordinated polymer. Bilirubin and bilirubinate free radical complexes may play an important role in pigment gallstone formation.