Gallstones (Cholelithiasis) Questions & Answers

Updated: Apr 01, 2019
  • Author: Douglas M Heuman, MD, FACP, FACG, AGAF; Chief Editor: BS Anand, MD  more...
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Questions & Answers

Overview

What is cholelithiasis (gallstone disease)?

What are the stages of gallstone disease (cholelithiasis)?

What causes gallstone disease (cholelithiasis) complications?

What are the characteristics of biliary colic?

Do asymptomatic patients with gallstones (cholelithiasis) present with abnormal physical findings?

How is uncomplicated biliary colic distinguished from acute cholecystitis?

What symptoms of gallstone disease (cholelithiasis) should be examined for further complications?

What type of lab tests are most beneficial in the diagnosis of uncomplicated cholelithiasis (gallstones) or simple biliary colic?

What imaging studies are useful in the diagnosis of gallstones (cholelithiasis)?

Are treatment options for gallstones (cholelithiasis) based on disease stage?

Which medical treatments are used for gallstones (cholelithiasis)?

When is cholecystectomy indicated in the treatment of gallstones (cholelithiasis)?

What are the surgical interventions for gallstones (cholelithiasis)?

What are gallstones (cholelithiasis)?

How do gallstones (cholelithiasis) develop?

What is choledocholithiasis?

What are initial and chronic complications of gallstones (cholelithiasis)?

What is the initial procedure used to diagnosis gallstone disease (cholelithiasis)?

When is surgical intervention indicated in the treatment of gallstones (cholelithiasis)?

How are gallstones formed?

How are cholesterol gallstones formed?

Which factors determine whether cholesterol gallstones will form?

What is the role of bilirubin in the formation of gallstones?

What is the role of bacteria in the formation of gallstones?

How are mixed gallstones formed?

Do all types of gallstones have identical risk factors?

What are the risk factors for development of cholesterol gallstones?

Is pregnancy a risk factor for the development of cholesterol gallstones?

Which causes of gallbladder stasis increase the risk for development of gallstones?

What medications increase the risk for the formation of gallstones?

Is there a genetic predisposition for gallstone (cholelithiasis) formation?

Which disorders predispose to black and brown pigment gallstones?

What comorbidities are associated with gallstones (cholelithiasis)?

What factors affect the prevalence of cholelithiasis (gallstones)?

What is the incidence of gallstones (cholelithiasis) in the US?

What is the mortality rate of gallstone disease (cholelithiasis) in the US?

What is the worldwide incidence of cholelithiasis (gallstones)?

Why is choledocholithiasis more prevalent outside the US?

Are there racial differences in the prevalence of gallstones (cholelithiasis)?

Are gallstones (cholelithiasis) more common in women or men?

Does the risk for development of gallstones (cholelithiasis) vary with age?

What is the prognosis of gallstones (cholelithiasis)?

What are potential complications following cholecystectomy performed for gallstones (cholelithiasis)?

What percentage of patients with gallstones (cholelithiasis) develop choledocholithiasis and what is the prognosis without surgery?

What education should be provided to asymptomatic patients with gallstones (cholelithiasis)?

Presentation

What are the different stages of gallstone disease (cholelithiasis)?

Do asymptomatic gallstones (cholelithiasis) require treatment?

What is biliary colic?

What are the symptoms and complications of biliary colic?

What are the physical findings of stage 1 (lithogenic state) gallstone disease (cholelithiasis)?

How is uncomplicated biliary colic differentiated from acute cholecystitis?

What are the differences in symptoms and physical findings between uncomplicated biliary colic and acute cholecystitis?

What are the physical findings associated with choledocholithiasis?

What are the physical finding associated with ascending cholangitis?

What are the physical findings associated with acute gallstone pancreatitis?

What are the complications of gallstones (cholelithiasis)?

What are the complications of gallstones (cholelithiasis) in the common bile duct?

What are the complications of inflammation due to chronic cholelithiasis (gallstones)?

DDX

What should be included in the differential diagnoses of gallstones (cholelithiasis)?

What are the differential diagnoses for Gallstones (Cholelithiasis)?

Workup

Is lab testing required to diagnosis gallstones (cholelithiasis)?

How are asymptomatic gallstones (cholelithiasis) diagnosed?

What blood tests are helpful in the workup of suspected gallstone (cholelithiasis) complications?

Which blood tests are helpful in the diagnosis of choledocholithiasis?

How often should blood tests be repeated in suspected gallstone (cholelithiasis) complications?

What is the role of radiography in the evaluation of suspected gallstones (cholelithiasis)?

Why is ultrasonography the imaging study of choice in the workup of suspected gallstone disease (cholelithiasis)?

What are the ultrasonographic findings in gallstones (cholelithiasis)?

Why are common bile duct (CBD) stones frequently missed on ultrasonography?

What is the role of endoscopic ultrasonography (EUS) in the workup of suspected gallstones (cholelithiasis)?

Is laparoscopic ultrasound useful for bile duct imaging?

What is the role of CT scanning in the workup of suspected gallstones (cholelithiasis)?

When is CT scanning useful in the workup of suspected gallstones (cholelithiasis)?

What is the role of MRI in the diagnosis of gallstones (cholelithiasis)?

What is the role of technetium-99m (99m Tc) hepatoiminodiacetic acid (HIDA) scintigraphy in the diagnosis of gallstones (cholelithiasis)?

What is the role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of gallstones (cholelithiasis)?

What are the indications and contraindications for use of percutaneous transhepatic cholangiography (PTC) in the management of gallstones (cholelithiasis)?

Treatment

When is surgical intervention indicated in the treatment of gallstones (cholelithiasis)?

What is the role of medical therapy in the management of gallstones (cholelithiasis)?

Which medications are used for the management of gallstones (cholelithiasis)?

When is medical treatment of gallstones the most effective?

Is surgical intervention recommended for asymptomatic gallstones (cholelithiasis)?

When should cholecystectomy be considered for asymptomatic gallstones (cholelithiasis)?

When should elective cholecystectomy be considered for gallstones (cholelithiasis)?

What is the role of dissolution agents in the treatment of gallstones (cholelithiasis)?

What referrals should be made by emergency department (ED) physicians to patients with symptomatic gallstones (cholelithiasis)?

When is cholecystectomy indicated for symptomatic gallstones (cholelithiasis)?

Which additional procedures may be considered at the time of cholecystectomy for gallstones (cholelithiasis) and suspected common bile duct stones?

What are the SAGES guidelines for laparoscopic surgery in symptomatic gallstones (cholelithiasis)?

What are the most serious complications of cholecystectomy in patients with gallstones (cholelithiasis)?

When is cholecystostomy indicated for gallstones (cholelithiasis)?

What is the role of sphincterotomy in the treatment of gallstones (cholelithiasis)?

What is the role of intraoperative endoscopic sphincterotomy (IOES) during laparoscopic cholecystectomy for gallstones (cholelithiasis)?

Can ursodeoxycholic acid treatment and dietary modification prevent formation of gallstones (cholelithiasis)?

Are dietary changes effective in reducing the risk of development of gallstones (cholelithiasis)?

Does regular exercise reduce the risk of development of gallstones (cholelithiasis)?

Which specialists should be consulted for gallstones (cholelithiasis)?

What are possible complications following cholecystectomy for gallstones (cholelithiasis)?

Medications

Which medications in the drug class Gallstone Dissolution Agents are used in the treatment of Gallstones (Cholelithiasis)?