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Cholelithiasis

Hongyi Cui, M.D., Ph.D. Reviewed 06/2022
 


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

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

  • Episodic right upper quadrant or epiga...

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
Chung AY, Duke MC. Acute Biliary Disease. Surg. Clin. North Am. 2018 Oct;98(5):877-894.
2
Burstow  MJ, Yunus  RM, Hossain  MB, et al. Meta-analysis of early endoscopi...

ADDITIONAL READING

Peponis  T, Eskesen  TG, Mesar  T, et al. Bile spillage as a risk factor for surgical site infection after laparoscopic cholecystectomy: a prospective study of ...

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 gallstones are asymptomatic.

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

  • Laparoscopic cholecystectomy is the preferr...

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