Evaluation of gallstone classification and their diagnosis through serum parameters as emerging tools in treatment: a narrative review

ABSTRACT

The treatment of gallstones is a matter of real concern as they may cause gallbladder cancer if not properly attended to. Evaluating the classification of gallstones can give major clues in their treatment as it will decide their etiology, chemical composition, and pathogenesis. Also, serum parameters have emerged as an efficient tool for diagnosing gallstones. They can be probed to evaluate different biochemicals and the changes in their levels in gallstone patients which can be correlated with early prediction of the formation of gallstones. In the present review, a thorough search of the available literature was done starting from the earliest approaches for the classification of gallstones up to the recent advancements. The alteration in the level of serum parameters was also studied in gallstone patients so that it can act as a potential diagnostic tool for early detection of gallstone formation. The earliest classification of gallstones was done in 1896 by Naunyn. He classified them into pure cholesterol stones, laminated cholesterol stones, ordinary gallbladder stones, mixed bilirubin stones, and rare forms. The most recent classification of gallstones was done by Peter et al in 2020 and they classified them as pure, mixed, composite cholesterol, carbonate stones, black and brown pigment stones. The altered of levels of serum parameters was analyzed by Reuben (1985) and in recent times by Peter et al (2020). The various serum parameters studied were as RDW-CV test (red blood cell distribution width), PCT (prolactin) test, MPV (mean platelet count), LYM (lymphocyte) test, and EOS (eosinophil and eosinophil count test). Also, we discussed some practical considerations for gallstones that can be taken into account for gallstone prevention and diagnosis. Further research is required to detect gallstone type in the gallbladder by using the alteration in the levels of serum parameters.

KEYWORDS:

• Gallstone classification
• cholesterol gallstones
• pigmented gallstones
• mixed gallstones
• serum parameters

Acknowledgments

The authors acknowledge the Birla Institute of Technology, Mesra, Ranchi for providing the Lab facilities. Bhavna Sharma acknowledges Birla Institute of Technology for providing Institute Research fellowship (GO/Estb/Ph.D/IRF/2019-20/6649).

Biographical statement

Dr Shubha Rani Sharma is an Assistant Professor in the Department of Bioengineering and Biotechnology. Her fields of interest are medical microbiology, gallstones research and OCT. Bhavna Sharma is a PhD Scholar in the Department of Bioengineering and Biotechnology. Her research is mainly focussed on gallstones classification and treatment and gallbladder cancer.

Disclosure statement

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethical approval

Ethical approval with Memo No. 125 I.E.C./I.A.E.C. was obtained from Institutional Ethics Committee of Rajendra Institute of Medical Sciences (RIMS), Ranchi.

Additional information

Funding

No funding was received for the production of this manuscript.