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Bile samples were obtained from 15 patients with gastric cancer or other lesions without biliary tract disease as a control and from 13 patients having cholesterol gallstones at laparotomy. One mixed stone was cut in half and thin serial sections, 10 microns in thickness, were prepared from the cut surface after Nakamura's method. The solubility of cholesterol in these gallstone sections after emersion in the bile samples was observed microscopically withdrawing the sections 1 hour, 3 hours, 5 hours and 24 hours. Among 15 control bile samples, a dissolution was observed in 9 gallstone sections after 1 hour, and in 6 sections after 3 and 5 hours. Bile samples of cholesterol stone cases had dissolved 3 sections after 1 hour, 7 sections after 3 and 5 hours. Dissolution did not occur in the remaining 3 sections. In bile composition, cholesterol (Ch) and total bile acid concentrations (TBA) in the controls were significantly higher than in bile of the cholesterol gallstone cases (P<0.05, P<0.02). Correlation between the bile composition and the solubility of cholesterol showed that bile samples having high TBA concentrations exhibited a greater dissolution ability even when the molar ratio of TBA to Ch were the same in both control and cholesterol gallstone bile. These findings lead us to conclude that the solubility of cholesterol in bile can not be expressed merely in terms of relative concentrations of Ch, phospholipid and TBA as the absolute concentrations of TBA also greatly influences the dissolution ability.
財団法人日本消化器病学会の論文

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