Different Surface Appearances Caused by Unbalanced Mn2+ Accumulation in Gallstones Consisting of Cholesterol and CaCO3 Obtained from a Patient After Cholecystectomy.

Gallstones were examined for 58 patients in Jilin, Jilin. It was found that gallstones from only one who suffered from cholecystectomy were composed of 20 spheroidal stones and they rarely exhibited three different types of surface appearances. Six representative powder samples were analyzed for gallstones compositions and Mn2+ using X-ray diffraction (XRD)/Infrared (IR) and electron spin resonance (ESR), respectively. The results suggested that all gallstones from this patient were identified by XRD to be gallstones consisting mainly of cholesterol and CaCO3 (GCCC). They rarely exhibited three different kinds of surface appearances corresponding to different concentration of trace Mn2+ in calcite (CMn2+/CCal): 18 dark/light brown spheres with smooth surfaces and CMn2+/CCal = 0-6 μg/g/%, a yellowish-brown huge sphere with a rougher surface and CMn2+/CCal = 30 μg/g/%, and an ashy sphere composed of tens of microspheres with the roughest surface and CMn2+/CCal = 60 μg/g/%. The difference in surface appearance showed significant association with CMn2+/CCal, and its increase made the gallstone's surface change from smooth to rough and to fade in color. The unbalanced and competitive Mn2+ accumulation could occur occasionally in individual stones owing to different affinities to Mn2+, resulting in the formation of a huge stone and an ashy sphere. These two aberrations caused by higher CMn2+/CCal played an important role in suppressing the crystalline growth of the majority of dark/light brown spheres. GCCC from a patient might have a prominent Mn2+ partitioning feature corresponding to different surface appearances.