Calcium palmitate and cholesterol gallstones

: Ca-palmitate is an abundant secondary constituent of cholesterol gallstones, especially of "multiple facet" and "barrel" stones. 60% of the 146 stones obtained by operation or autopsy contained crystalline Ca-palmitate. From these 70% were multiple and 11% solitary stones. The average percentage of Ca-palmitate calculated from 30 quantitative analyses amount to 1,75% with regard to the dry weight of stones. The occurrence of Ca-palmitate in gallbladder stones mainly depends on concrements which undergo structural alterations (formation of fissures for example) during their stay in the gallbladder and which are impregnated by bile. Ca-palmitate crystallizes within the fissures of these stones after concentration of included bile. There is no important hint that Ca-palmitate plays a role in stone nucleation. The occurence of Ca-palmitate in bile may be favoured by decreased micellar solubilization of palmitinic acid and by increased concentration of Ca as a result of inflammation.