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
