[Pathogenesis and animal model of gallstone disease]

Both cholesterol and pigment gallstones are multifactorial diseases. The broad outlines of the mechanism and limit of cholesterol solubilization in bile are well-understood, whereas the physical-chemical solubilities of unconjugated bilirubin and other calcium salts remain unclear. The importance of crystallization kinetics in gallstone formation is also well-recognized and several protein determinants of such process have been reported in bile. The chances of crystal growth and stone formation are further enhanced by mucus hypersecretion and gallbladder hypomotility. The use of animal models will continue to be useful not only in promoting our understanding of the pathogenesis but also in developing new chemicals for dissolution and prevention of gallstone diseases.