Various Techniques for the Surgical Treatment of Common Bile Duct Stones: A Meta Review

Table 1

Classification of gallstones [5].

	Cholesterol	Brown-pigment stone	Black-pigment stone
Origin	Gallbladder (secondary stones)	Ducts ± gallbladder (primary stones)	Gallbladder ± ducts (primary or secondary stones)
Component	40–70% cholesterol	15% cholesterol	2% cholesterol
		60% calcium bilirubinate	6% calcium carbonate
		15% calcium phosphate	40% calcium bilirubinate
			9% calcium phosphate
Predisposing factor	–Obesity	–Diet: low protein, high carbohydrate	–Cirrhosis
	–↓Bile duct pool	–Cholangitis	–Chronic hemolysis
	–↑Cholesterol synthesis	–Biliary stricture	–Sickle cell anemia
	–↑Progesterone	–Biliary infections: bacterial, parasitic	–Heart valve replacement
		–Biliary stasis: total parenteral nutrition, vagotomy
Shape, size, number	Multiple: smooth faceted	Smooth, round	Multiple, irregular, or smooth
	Single: ≥2.5 cm, smooth, round	1–3 cm	usually <0.5 cm
Physical characteristics	Hard, laminated	Hard	Soft, friable