Showing the Gallbladder

Types of Gallstones

There are two main types of gallstones that form in the gallbladder and bile ducts. The types are named by what they are primarily made of—cholesterol and pigment. Pigment stones are further categorized into brown or black stones. In most industrialized countries, the majority of gallstones are cholesterol stones, but in Asian countries, pigment gallstones prevail. (vii.122-124)

Gallstone types have different characteristics: (vii.122-124, 129)

Table VII.19: Characteristics of Different Types of Gallstones
Composition Size & Appearance Other Characteristics
  • Greater than 50% cholesterol
  • Calcium bile salts
  • Mucin
  • Up to 4 cm
  • Yellow to brown in color
  • Faceted or round

Most common type in industrialized countries.

Risk is 3 times higher in women and even greater in those who use oral contraceptives and those with multiple pregnancies.

Black Pigment
  • Primarily bilirubin compounds (from the breakdown of red blood cells)
  • Less than 30% cholesterol
  • Calcium bile salts
  • Mucin
  • Up to 1 cm
  • Round or irregular shape

More common in older and/or poorly nourished people.

Conditions that increase the breakdown of red blood cells (e.g., cirrhosis of the liver, thalassemia, and sickle cell anemia) increase the risk of black gallstones.

  • Compounds made from bilirubin and bacterial enzymes
  • Less than 30% cholesterol
  • Compounds made of cholesterol, calcium, & fatty acids
  • Mucin
  • Larger than 1 cm
  • Round or irregular shape

Unlike other types, brown gallstones are more common in the liver bile ducts rather than the gallbladder.

Which release bile into the first part of the small intestines,
an area called the duodenum. (vii.124)
A slimy mucous secretion. (vii.86)

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