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Cholelithiasis

Hongyi Cui, MD, PhD, FACS, FICS Reviewed 06/2018
 


BASICS

DESCRIPTION

  • The presence of cholesterol, pigment, or mixed stones (calculi) within the gallbladder

  • Synonym(s): gallstones

Pediatric Considerations

  • Uncommon in children <10 years

  • Most gallstones i...

DIAGNOSIS

HISTORY

  • Mostly asymptomatic (80%): 2% become symptomatic each year. Over their lifetime, <50% of patients with gallstones develop symptoms.

  • Episodic right upper quadrant or epigastric pain ...

TREATMENT

GENERAL MEASURES

  • Treat symptomatic cholelithiasis.

  • Conservative therapy is preferred during pregnancy. Surgery in the 2nd trimester if necessary.

  • Prophylactic cholecystectomy for patients with ...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Follow for signs of symptomatic cholelithiasis.

  • Follow patients on oral dissolution agents with serial liver enzymes, serum cholesterol, and imag...

REFERENCES

1
1 Sanabria A, Dominguez LC, Valdivieso E, et al. Antibiotic prophylaxis for patients undergoing elective laparoscopic cholecystectomy. Cochrane Database Syst Rev.  2010;(12):CD005265....

ADDITIONAL READING

  • Brown LM, Rogers SJ, Cello JP, et al. Cost-effective treatment of patients with symptomatic cholelithiasis and possible common bile duct stones. J Am Coll Surg.  2011;212(6):10...

SEE ALSO

Cholangitis, Acute; Choledocholithiasis 

CODES

ICD10

  • K80.20 Calculus of gallbladder w/o cholecystitis w/o obstruction

  • K80.21 Calculus of gallbladder w/o cholecystitis with obstruction

  • K80.01 Calculus of gallbladder w acute cholecystitis w obstr...

CLINICAL PEARLS

  • Most patients with gallstones are asymptomatic.

  • Transabdominal US is the imaging modality of choice for diagnosis of cholelithiasis (sensitivity, 97%; specificity, 95%).

  • LC is the prefer...

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