STRUCTURE AND COMPOSITION OF PRIMARY INTRAHEPATIC STONES IN KOREAN PATIENTS

We have analyzed the chemical composition of primary intrahepatic ston es from 72 Korean patients. Two types of concretions have been identif ied: brown pigment (calcium bilirubinate) stones and black-colored mix ed stones. Brown pigment stones were found in 68% of all cases and the remainder (32%) consisted of mixed stones. Intrahepatic mixed stones had mean cholesterol and bilirubin contents of 46.6% and 25.9%, respec tively, whereas calcium bilirubinate stones had mean cholesterol and b ilirubin contents of 14.1% and 43.6%, respectively. Intrahepatic mixed stones had a smooth black-colored surface and on cross section, exhib ited a distinct outer shell surrounding an inner yellow, cholesterol-r ich body. The finding of intrahepatic mixed stones with high cholester ol content suggests that primary hepatolithiasis may result from at le ast two different conditions or disorders and points to different appr oaches to their treatment.