- Gallstones are "stones" that form in the gallbladder or bile ducts.
- The common types of gallstones are cholesterol, black pigment, and brown pigment.
- Cholesterol gallstones occur more frequently in several ethnic groups and are associated with femalegender, obesity, pregnancy, oral hormonal therapy, rapid loss of weight, elevated blood triglyceride levels, and Crohn's disease.
- Black pigment gallstones occur when there is increased destruction of red blood cells, while brown pigment gallstones occur when there is reduced flow and infection of bile.
- The majority of gallstones do not cause symptoms.
- The most common symptoms of gallstones are biliary colic and cholecystitis. Gallstones do not cause intolerance to fatty foods, belching, abdominal distention, or gas.
- Complications of gallstones include cholangitis, gangrene of the gallbladder, jaundice, pancreatitis, sepsis, fistula, and ileus.
- Gallbladder sludge is associated with symptoms and complications of gallstones; however, like gallstones, sludge usually does not cause problems.
- The best single test for diagnosing gallstones is transabdominal ultrasonography. Other tests include endoscopic ultrasonography, magnetic resonance cholangio-pancreatography (MRCP), cholescintigraphy (HIDA scan), endoscopic retrograde cholangio-pancreatography (ERCP), liver and pancreaticblood tests, duodenal drainage, oral cholecystogram (OCG), and intravenous cholangiogram (IVC).
- Gallstones are managed primarily with observation (no treatment) or removal of the gallbladder (cholecystectomy). Less commonly used treatments include sphincterotomy and extraction of gallstones, dissolution with oral medications, and extra-corporeal shock-wave lithotripsy (ESWL). Prevention of cholesterol gallstones also is possible with oral medications.
- Symptoms of gallstones should stop following cholecystectomy. If they do not, it is likely that the gallstones were left in the ducts, there is a second problem within the bile ducts, orthere is sphincter of Oddi dysfunction.
- Continuing research is directed at uncovering the genes that are responsible for the formation of gallstones.
Reviewed on 4/11/2014
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