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Semin Liver Dis 2024; 44(03): 394-404
DOI: 10.1055/a-2378-9025
Review Article

Gallstones: Prevention, Diagnosis, and Treatment

Frank Lammert
1   Health Sciences, Hannover Medical School (MHH), Hannover, Germany
,
Henning Wittenburg
2   Internal Medicine II, Helios Klinik Schleswig, Schleswig, Germany
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Abstract

Gallstones are common and affect up to 20% of the general adult population and >20% of them will develop symptoms or complications of cholelithiasis. The high risk of gallbladder stone formation can be reduced by ursodeoxycholic acid in the case of significant weight reduction resulting from diet or bariatric surgery. Laparoscopic cholecystectomy is indicated for symptomatic gallstones, as the risk of recurrence or complications increases over the course of the disease. Biliary colic is treated with nonsteroidal anti-inflammatory drugs and spasmolytics; opioids can also be used in cases of severe acute pain. Acute cholecystitis represents a common complication of gallbladder stones and a cholecystectomy should be performed early electively, i.e., within 24 hours of admission to hospital. Symptomatic bile duct stones are primarily treated endoscopically. Immediate anti-infective therapy is mandatory in acute cholangitis. Although knowledge on the genetics and pathophysiology of gallstones has increased, current treatment algorithms remain predominantly invasive, based on interventional endoscopy and surgery. Future efforts should focus on novel strategies to prevent the development of gallstones.

Keywords

cholelithiasis - cholecystectomy - endoscopic retrograde cholangiography - genetic risk factors - ursodeoxycholic acid


Publication History

Accepted Manuscript online:
02 August 2024

Article published online:
02 September 2024

© 2024. Thieme. All rights reserved.

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