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Open Access Research article

Can the type of gallstones be predicted with known possible risk factors?: a comparison between mixed cholesterol and black pigment stones

Harshi TW Weerakoon1*, Jamburagoda GS Ranasinghe2, Ayanthi Navaratna3, Ramaiah Sivakanesan2, Kuda B Galketiya4 and Shanthini Rosairo4

Author Affiliations

1 Department of Biochemistry, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka

2 Department of Biochemistry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka

3 Department of Chemistry, Faculty of Science, University of Peradeniya, Peradeniya, Sri Lanka

4 Department of Surgery, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka

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BMC Gastroenterology 2014, 14:88  doi:10.1186/1471-230X-14-88

Published: 6 May 2014



Pathogenesis of gallstones (GS) is multifactorial and multiple genetic and environmental factors have been identified in different populations for different types of GS with varying prevalence. However the role of the each aetiological factor on the formation of mixed cholesterol and black pigment GS has not being addressed adequately. Hence in this study we attempted to compare known possible risk factors for mixed cholesterol and black pigment GS among two groups of patients with two types of GS.


The study was done on a cohort of patients with symptomatic GS admitted to the Teaching Hospital Peradeniya, Sri Lanka over a period of 18 months. Clinical and epidemiological data and physical parameters of the patients were recorded and surgically removed GS were analyzed chemically and physically to identify the type of GS. In addition lipid profile was done in all the patients with normal serum bilirubin levels.


A total of 86 patients were included in the study. Mixed cholesterol GS was significantly common among females than males (χ2 test, p = 0.029). Mixed cholesterol GS was commonly seen among patients belonging to Moor ethnicity (χ2 test, p = 0.009). Majority of patients with mixed cholesterol GS had body mass index above 25 kg/m22 test, p = 0.018). Black pigment GS were significantly common among patients with type II diabetes mellitus (Fisher’s exact test, p = 0.035). Further all the patients with chronic haemolytic anaemia and alcoholic cirrhosis had black pigment GS. Age, family history, Fasting Blood Glucose, dyslipidaemia, lipid profile, parity and use of oral contraceptive pills in females, smoking and alcohol intake in males did not differ significantly among patients in the two groups.


Gender, ethnicity and body mass index can be used to predict the formation of mixed cholesterol GS and black pigment GS.

Gallstones; Risk factors; Mixed cholesterol; Black pigment