What are the types of cholelithiasis (gallstones)?

From the Guidelines

There are three categories of cholelithiasis (gallstones): silent gallstones (asymptomatic disease), symptomatic disease with uncomplicated biliary pain, and complications of gallstone disease, such as acute cholecystitis and gallbladder cancer. The categorization of disease into these categories allows clinicians and patients to choose the treatment most appropriate to the specific patient 1. Some key points to consider when evaluating gallstone disease include:

• The efficacy, safety, and benefits of each treatment option, including expectant management, nonsurgical therapy, and surgical approach 1
• The diameter and composition of the gallstones, as certain treatments are limited to gallstones with a diameter less than 1.5 cm and whose content is primarily cholesterol 1
• The potential risks and complications of each treatment option, including the risks of delaying intervention and the potential for adverse consequences 1 It is essential to note that the provided evidence does not explicitly mention the composition of gallstones, such as cholesterol stones or pigment stones. However, the evidence does discuss the different categories of gallstone disease and the various treatment options available. In real-life clinical practice, understanding the category of gallstone disease and the treatment options available is crucial for determining the most appropriate treatment approach and improving patient outcomes. Some general tips for preventing gallstone formation include:
• Maintaining a healthy weight
• Eating a balanced diet low in saturated fats
• Exercising regularly
• Staying hydrated If symptoms like severe abdominal pain, nausea, or vomiting occur, seeking medical attention immediately is essential. Treatment may involve medication to dissolve stones or surgery (cholecystectomy) to remove the gallbladder, depending on the category of gallstone disease and the individual patient's needs.

From the Research

Types of Cholelithiasis (Gallstones)

The types of gallstones can be classified based on their composition. The main types of gallstones are:

• Cholesterol gallstones, which are the most common type 2, 3, 4
• Bilirubin ('pigment') stones, which can be further divided into:
  • Black pigment stones, often caused by chronic haemolysis 2, 3, 5
  • Brown pigment stones, typically developing in obstructed and infected bile ducts 2, 3, 5
• Mixed stones, which contain a combination of cholesterol and pigment components 4

Composition of Gallstones

The composition of gallstones can vary, with cholesterol-rich stones being more common in Europe and North America 4. The chemical composition of gallstones can be classified into three main types: cholesterol, black pigment, and brown pigment stones 5.

Prevalence of Gallstone Types

The prevalence of different types of gallstones can vary, with cholesterol stones forming around 37-86% of cases, pigment stones forming around 2-27%, and mixed stones forming around 4-16% 4. In Southeast Asia, the prevalence of brown pigment stones appears to be decreasing, while Western-type cholesterol stones are becoming more common 5.