A FUNDAMENTAL STUDY ON DISSOLUTION AND DISINTEGRATION OF CALCIUM BILIRUBINATE STONE

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Solution of tetrasodium salt of ethylenediaminetetraacetic acid (EDTA 4Na), potent chelating agent, when incubated with slice of calcium bilirubinate stone, exhibited a yellow brown tint, which was spectroscopically characteristic of bilirubin. Microscopic examination of the slice revealed dissolution of granules of calcium bilirubinate, leaving behind a reticular matrix of PAS-positive substance. The efiect of EDTA 4Na was influenced by pH, being fully effective only at pH 10 or more, and by temperature and concentration as well. Simultaneous application of bile salt enhanced the activity of EDTA 4Na, hydrophilizing the gallstone surface to facilitate chelating reaction and also dissolving minor fatty components of the stone. Heparin at proper concentration also promoted disintegration of the stone, changing surface potential of its constituent particles to the dispersionprone charge. The effect of composite EDTA 4Na-bile salt-heparin was thus significantly greater than that of single EDTA 4Na. This mixture is promising for clinical application as a means of direct dissolution of residual gallstones.
財団法人日本消化器病学会の論文