Gallstones are very common in the United States and other Western countries. Treatment of cholelithiasis and its complications frequently requires hospital admission and significant utilization of health care resources. The pathogenesis of gallstone formation is complicated and involves multiple metabolic and physiologic abnormalities. Two-thirds of gallstones are asymptomatic and require no treatment. Patients with symptomatic disease may have a variety of clinical manifestations, ranging from relatively short and self-limited (biliary colic) to life-threatening conditions (cholangitis, pancreatic necrosis, and phlegmon). This article describes current approaches to diagnosis and treatment of the most common clinical conditions caused by gallstones: biliary colic, acute cholecystitis, choledocholithiasis, and acute gallstone pancreatitis. The authors have especially emphasized the role of widely used imaging techniques (transabdominal ultrasound, CT scan, MR imaging, and MRCP) and diagnostic and therapeutic endoscopy (endoscopic ultrasound, ERCP). This review is mainly intended for general practitioners, primary care physicians, and other specialists who provide medical care to patients with gallstones and complications associated with this condition.
ASJC Scopus subject areas
- Pharmacology (medical)