Gallstone Disease

Gallstone Disease is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • Asymptomatic gallstones (cholelithiasis) are a common incidental finding for which no specific therapy is generally necessary. Cholesterol stones are the most common type, but pigmented stones can be seen with hemolysis or infection. Risk factors include obesity, female gender, parity, rapid weight loss, ileal disease, and maternal family history.
  • Symptomatic cholelithiasis, when upper abdominal symptoms are linked to gallstones, is typically treated surgically with cholecystectomy.
  • Acute cholecystitis is caused most often by a gallstone obstructing the cystic duct, but acalculous cholecystitis can occur in critically ill patients.
  • Choledocholithiasis refers to stones within the bile ducts.
  • Cholangitis is infection of the bile ducts, usually caused by an impacted gallstone in the distal bile duct.

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General Principles

  • Asymptomatic gallstones (cholelithiasis) are a common incidental finding for which no specific therapy is generally necessary. Cholesterol stones are the most common type, but pigmented stones can be seen with hemolysis or infection. Risk factors include obesity, female gender, parity, rapid weight loss, ileal disease, and maternal family history.
  • Symptomatic cholelithiasis, when upper abdominal symptoms are linked to gallstones, is typically treated surgically with cholecystectomy.
  • Acute cholecystitis is caused most often by a gallstone obstructing the cystic duct, but acalculous cholecystitis can occur in critically ill patients.
  • Choledocholithiasis refers to stones within the bile ducts.
  • Cholangitis is infection of the bile ducts, usually caused by an impacted gallstone in the distal bile duct.

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