Title:Chemical Analysis of Gallstones of Nepali Patients
Volume: 12
Issue: 1
Author(s): Bijaya BK, Achyut Adhikari*Gobinda Gyawali
Affiliation:
- Central Department of Chemistry, Institute of Science and Technology, Tribhuvan University, 44618, Kirtipur, Kathmandu, Nepal
Keywords:
Gallstone, calcium bilirubinate, cholesterol, SEM, EDS, UV-Vis.
Abstract:
Background: The bile concretions formed inside the gallbladder are called gallstones.
Gallstone disease is one of the major causes of morbidity, mortality, and economic burden throughout
the world. Approximately 10% to 20% of the world population and 4.87% in Nepal are suffering
from a gallstone.
Objective: The aim is to classify the gallstone samples based on morphological and cross-sectional
evidences, and a comparative study of their chemical composition to understand the mechanism of
formation.
Methods: Two types of gallstones were studied; combined cholesterol gallstone and black pigment
gallstone. SEM, UV-Vis, and EDS analyzed the gallstones for morphological and elemental study.
Results: The UV-Vis spectrum showed characteristic peaks for cholesterol, calcium bilirubinate,
and copper bilirubinate. SEM image of combined cholesterol gallstone reveals that cholesterol is the
major phase in the shell, whereas bilirubin is the major phase in the core. EDS detection of C and O
as the major elements confirmed cholesterol, whereas the detection of C, O, N, and Ca as the major
elements confirmed bilirubin. In the shell of the black pigment gallstone, cholesterol, calcium carbonate,
calcium phosphate, and bilirubinate were detected, whereas, in the core, bilirubinate of calcium
and copper, cholesterol, protein, and calcium carbonate were detected.
Conclusion: Cholesterol and bilirubin are the major components of the gallstones. Metals like Al,
Ca and Cu play a crucial role in the initial formation of the gallstones. The combined cholesterol
gallstone has a yellow pigment center composed mainly of unconjugated bilirubin and an outer shell
primarily composed of cholesterol and calcium carbonate. Precipitation of bilirubinate of calcium
and copper is important during the formation of black PGS.
