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Article
September 5, 1931

ETIOLOGY OF GALLSTONES

JAMA. 1931;97(10):709. doi:10.1001/jama.1931.02730100033013
Abstract

One of the perennial problems confronting the pathologist is the etiology of gallstones. These calculi ordinarily consist of cholesterol alone or in admixture with bile pigments, calcium phosphate and adventitious iron in various proportions. The condition of the bile in the gallbladder, where gallstones usually develop, appears to be uniquely favorable for the precipitation of those biliary constituents of which the calculi consist. Water is rapidly removed from the bile in the gallbladder, which has the effect of increasing the concentration of all the substances in solution that are not absorbed along with the water. Furthermore, as has been pointed out again by Elman and Taussig,1 liver bile which has been subjected to the influence of the mucosa of the gallbladder contains far more cholesterol per gram of hepatic tissue drained than does the bile drawn off directly from the hepatic ducts. This increase in cholesterol is much greater

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