Med. praxi. 2010;7(5):235-237

Diagnosis and treatment of cholecystolithiasis

prof.MUDr.Julius Špičák, CSc.

Klinika hepatogastroenterologie IKEM, Praha

The prevalence of cholelithiasis is 10–20 %. It rises with age, with women being affected more often than men. Cholesterol stones are

most common, other risk factors include pregnancy and reduced food intake. Black pigmented stones occur in cirrhosis and haemolytic

anaemia, brown ones arise in the bile duct during inflammation. Most patients are asymptomatic; the symptoms and complications

include colics, dyspepsia, cholecystitis, cholangitis, abscess, biliary ileus and gallbladder cancer. The superior diagnostic method for

cholecystolithiasis is ultrasonography; in case of complications related to possible biliary obstruction and during cholecystectomy,

investigations of the bile duct with magnetic resonance imaging, CT, radiography or endosonography are considered. Symptomatic

cholecystolithiasis is managed with cholecystectomy, in asymptomatic cases bariatric surgery and colectomy are considered in case of

large stones. In cholecystitis, early cholecystectomy should be the preferred method; conservative treatment involves spasmolytics,

parenteral nutrition and antibiotics. When there is a high operative risk, transabdominal or transpapillary drainage is performed. The

risk of the disease, its complications and surgery increases with age and comorbidities.

Keywords: cholecystolithiasis, choledocholithiasis, cholecystectomy, ERCP, endosonography

Published: June 1, 2010  Show citation