Figure 1.
The appearance of each type of gallbladder stone.
A. Cholesterol stone B. Pigment stone C. Calcium carbonate stone D. Phosphate stone E. Calcium stearate stone F. Protein stone G. Cystine stone H. Cholesterol- bilirubinate mixed stone I. Bilirubinate -calcium carbonate mixed stone J. Bilirubinate -phosphate mixed stone.
Figure 2.
A typical IR spectrogram of the three most common gallbladder stone types.
A. Cholesterol stone: 1466, 1377, and 1057 cm−1 were the characteristic absorption peaks of cholesterol. B. Pigment stone: 1663, 1629, 1570, and 1247 cm−1 were the characteristic absorption peaks of bilirubin and bilirubinate. C. Calcium carbonate of calcite type: 1436, 875, and 712 cm−1 were the characteristic absorption peaks of calcium carbonate of calcite type. D. Calcium carbonate of aragonite type: 1494, 854, 713, and 700 cm−1 were the characteristic absorption peaks of calcium carbonate of aragonite type.
Figure 3.
A typical IR spectrogram of four rare gallbladder stone types.
A. Phosphate stone: 1036, 605, 564 were the characteristic absorption peaks of phosphate. B. Calcium stearate stone: 2917, 2849, 1575, 1540, 1470, 1112, and 721 cm−1 were the characteristic absorption peaks of calcium stearate. C. protein stone: 1756, 1661, 1575, 1541, 1370, and 1039 cm−1 were the absorption peaks of protein. D. cystine stone: 1622, 1566, 1490, 1409, 847, and 541 cm−1 were the absorption peaks of cystine.
Figure 4.
A typical IR spectrogram of four common mixed gallbladder stone types.
A. Cholesterol- bilirubinate mixed stone: 1666, 1570, and 1246 cm−1 were the absorption peaks of bilirubin and bilirubinate, while 1463, 1377, and 1056 cm−1 were those of cholesterol. B. Cholesterol- calcium carbonate mixed stone: 1467, 1377 and 1056 cm−1 were the absorption peaks of cholesterol, while 1467, 874, 854, 712, 699 were those of calcium carbonate, and 1467 was the fusion peak of cholesterol and calcium carbonate. C. Bilirubinate-calcium carbonate mixed stone: 1663, 1572, and 1249 cm−1 were the absorption peaks of bilirubin and bilirubinate, while 1454, 874, 856, 700 and 686 cm−1 were those of calcium carbonate. D. Bilirubinate-phosphate mixed stone: 1663, 1572, and 1250 cm−1 were the absorption peaks of bilirubin and bilirubinate, while 1031, 603, and 560 cm−1 were those of phosphate.
Table 1.
Clinical characteristics of patients with each type of stone.
Table 2.
Proportion of different subtypes of mixed stones.
Figure 5.
Microstructure of the three most common gallbladder stone types (original magnification ×3000).
A, B. Cholesterol stone. A. Plate-like cholesterol crystals. B. Lamellar cholesterol crystals. C, D. Pigment stone. C. Clumping-like bilirubinate particles. D. Irregular bilirubinate particles. E – H. Calcium carbonate stone. E. Bulbiform and ellipsoid calcium carbonate crystals. F. Fusiform calcium carbonate crystal. G. Hawthorn-like calcium carbonate crystal. H. Cuboid calcium carbonate crystal.
Figure 6.
Microstructure of four rare gallbladder stone types.
A, B. Phosphate stone (original magnification ×6000). A. Echin-sphere phosphate particles. B. Rough bulbiform phosphate particles. C,D. Calcium stearate stone (original magnification ×6000). C. Calcium stearate presented as network structure. D. Calcium stearate presented as staggered arranged network, protein stone (original magnification×6000). E. Coralliform protein and bilirubinate complex. F. Chrysanthemum petal-like protein and bilirubinate complex. G, H. Cystine stone. G. Stacked hexagonal crystals, some with prominent edges (original magnification ×400). H. The prominent edges appeared lamellar after magnification (original magnification ×6000).
Figure 7.
Microstructure of mixed stones (original magnification ×3000).
A. Cholesterol- bilirubinate mixed crystals. B. Bilirubinate- calcium carbonate mixed crystals. C. Cholesterol- calcium carbonate mixed crystals. D. Bilirubinate- phosphate mixed particles. E. Bilirubinate- calcium stearate mixed particles. F. Cholesterol- phosphate mixed crystals. G. Cholesterol- bilirubinate- calcium carbonate mixed crystals. H. Cholesterol- bilirubinate- phosphate mixed crystals.
Table 3.
Elemental composition of each type of stone.