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Cholelithiasis

Hongyi Cui, M.D., Ph.D. Reviewed 05/2023
 


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...

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;98(5):877-894.
2
Garcia-Pagan JC, Francoz C, Montagnese S, Senzolo M, et al. Management of the major complications of cirrh...

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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