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Dtsch Med Wochenschr 2016; 141(23): 1677-1682
DOI: 10.1055/s-0042-113238
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Hepatobiliäre Erkrankungen
© Georg Thieme Verlag KG Stuttgart · New York

Gallensteine – Ursachen, Folgen und Therapieoptionen

Gallstones – Causes and Consequences
Katharina C. Grotemeyer
1   Klinik für Innere Medizin II, Universitätsklinikum des Saarlandes, Homburg
,
Frank Lammert
1   Klinik für Innere Medizin II, Universitätsklinikum des Saarlandes, Homburg
› Author Affiliations
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Publication History

Publication Date:
17 November 2016 (online)

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Zusammenfassung

Gallensteine und deren Komplikationen sind eines der häufigsten gastroenterologischen zur Krankenhausaufnahme führenden Krankheitsbilder im europäischen Raum. Darunter sind Cholesterinsteine die am häufigsten gebildeten Steine – mit einigen wenigen Ausnahmen lässt sich hier ein direkter Bezug zum Lebensstil herstellen. Adipositas, Diabetes und wenig körperliche Aktivität sind nur einige der Faktoren. Diagnostischer Goldstandard zur Detektion ist der abdominelle Ultraschall; dies gilt in Bezug auf Steine in der Gallenblase wie auch im Gallengang. Die ERCP ist der Therapie von Gallengangsteinen vorenthalten und als Diagnostikum obsolet. Bei symptomatischen Gallenblasen – und Gallengangsteinen ist eine Cholezystektomie indiziert – unabhängig vom Alter. Diese sollte möglichst frühzeitig erfolgen, um Rezidivkoliken und weitere Komplikationen zu vermeiden. Bei Vorliegen einer Infektion, wie z. B. einer akuten Cholezystitis, sollte heutzutage eine Cholezystektomie innerhalb von 24h nach stationärer Aufnahme werden.

Abstract

Gallstones and their complications are one of most frequent gastroenterological diseases leading to hospital admission in Europe. Cholesterol stones are the most common; except of few patients there is a direct link to lifestyle. Obesity, diabetes and insufficient physical activity represent the major risk factors. Abdominal ultrasound is the gold standard for detection of gallstones. ERCP is indicated only in the therapeutic setting. In case of symptomatic gallbladder stones as well as bile duct stones, cholecystectomy is necessary. Higher age is no contraindication. To avoid further biliary colic episodes and / or additional complications, cholecystectomy should be performed as early as possible. In case of acute cholecystitis, cholecystectomy should be performed within 24 h after admission.

Schlüsselwörter

Gallensteine - akute Cholezystitis - Choledocholithiasis

Keywords

Gallstones - bile duct stones - acute cholecystitis
 

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