Altered gallbladder motility by progesterone has been recognized as an impo
rtant factor in the development of gallstones. There are two types of hepat
olithiasis, that occurs de novo in the intrahepatic ducts with an intact ga
llbladder (primary hepatolithiasis) and that which originates in the gallbl
adder and the stones migrate into the intrahepatic duct (secondary hepatoli
thiasis). This study was designed to evaluate the possible role of the prog
esterone receptor of gallbladder in the pathogenesis of hepatolithiasis. Ei
ghty-four patients with hepatolithiasis (34 patients had primary hepatolith
iasis and the other 50 patients secondary hepatolithiasis) were included. P
araffin-embedded specimens of gallbladder were processed to have an immunoh
istochemical staining for progesterone receptor. Positivity for progesteron
e receptor of gallbladder specimens was noted in eight patients (23.5%) wit
h primary hepatolithiasis and in 23 patients (46%) with secondary hepatolit
hiasis. There is significant difference (P = 0.031) in positive rate for pr
ogesterone receptor between the primary hepatolithiasis and secondary hepat
olithiasis groups. In conclusion, many more patients (46%) with secondary h
epatolithiasis show positivity for progesterone receptor of gallbladder spe
cimens than patients with primary hepatolithiasis (23.5%) (P = 0.031). This
phenomenon is intriguing and should be of further evaluation and elucided.