Cholelithiasis (gallstones)

Gallstone disease (cholelithiasis) is highly prevalent, but most cases are asymptomatic.

Common risk factors include older age, female sex and pregnancy, obesity, rapid weight loss, drugs, and a family history of gallstones.

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 hospitalisation in developed countries.

Cholelithiasis is the presence of solid concretions (stones) in the gallbladder. Gallstones form in the gallbladder but may exit into the bile ducts (choledocholithiasis). Symptoms occur if a stone obstructs the cystic, bile, or pancreatic duct.

Most gallstones in developed countries (>90%) consist of cholesterol.[1]European Association for the Study of the Liver (EASL). EASL clinical practice guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol. 2016 Jul;65(1):146-81. https://www.journal-of-hepatology.eu/article/S0168-8278(16)30032-0/fulltext http://www.ncbi.nlm.nih.gov/pubmed/27085810?tool=bestpractice.com

This topic covers only the diagnosis and management of symptomatic uncomplicated cholelithiasis and asymptomatic or symptomatic choledocholithiasis. For detailed information on the diagnosis and management of patients with acute cholecystitis, acute cholangitis, or acute pancreatitis, see  Acute cholecystitis, Acute cholangitis, and Acute pancreatitis.