Gallstones are highly prevalent, but most (80%) are asymptomatic.
Symptoms occur when stones obstruct the cystic or bile ducts.
Cholesterol gallstone formation begins with the secretion of bile supersaturated with cholesterol from the liver. Initiated by nucleating factors such as mucin, microscopic crystals then precipitate in the gallbladder where hypomotility provides time for stone growth.
Common risk factors include older age, female gender and pregnancy, obesity, rapid weight loss, and a family history.
Abdominal ultrasound provides effective diagnostic imaging.
Laparoscopic cholecystectomy represents definitive treatment for symptomatic patients.
Complications such as cholecystitis, cholangitis, and pancreatitis develop in 0.1% to 0.3% of patients annually.
Gallstones are the most common gastrointestinal disease that requires hospitalization in the US.
Ultrasound of acute cholecystitis and presence of gallstones: the arrow points to a gallstone in the fundus of the gallbladder with its echogenic shadow below
Courtesy of Charles Bellows and W. Scott Helton
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