From the Guidelines
Cholelithiasis is the medical term for gallstones, which are hardened deposits that form in the gallbladder, and it is estimated that as many as 80% of patients with gallstones remain asymptomatic throughout their lives 1.
Definition and Pathogenesis
Cholelithiasis develops when substances in bile, primarily cholesterol and bilirubin, crystallize and form solid masses. Gallstones can vary in size from tiny grains to larger stones measuring several centimeters. They may cause no symptoms (asymptomatic cholelithiasis) or lead to complications such as biliary colic (intense pain in the upper right abdomen), cholecystitis (gallbladder inflammation), or blockage of bile ducts.
Risk Factors and Treatment
Risk factors include female gender, obesity, rapid weight loss, certain medications, and genetic predisposition. Treatment depends on symptom severity, ranging from watchful waiting for asymptomatic cases to surgical removal of the gallbladder (cholecystectomy) for symptomatic patients.
- Asymptomatic cholelithiasis is typically managed expectantly, with surgery reserved for those who become symptomatic or have high-risk conditions 1.
- Symptomatic cholelithiasis is classically suggested by the presence of biliary pain in the setting of known gallstones.
- Ultrasonography detects cholelithiasis in ∼98% of patients, and hepatobiliary scintigraphy can help diagnose acute cholecystitis 1.
Diagnosis and Management
The diagnosis of cholelithiasis is typically made using ultrasonography or hepatobiliary scintigraphy. Management depends on the presence and severity of symptoms, as well as the presence of any complications.
- For asymptomatic patients, watchful waiting is often recommended, as the risk of complications is low 1.
- For symptomatic patients, cholecystectomy is often recommended, as it can provide definitive treatment and prevent future complications 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Definition of Cholelithiasis
- Cholelithiasis refers to the formation of gallstones in the gallbladder 2.
- It is a common medical problem that can lead to surgical intervention, with approximately 500,000 cholecystectomies performed in the US every year 2.
- Cholelithiasis affects around 10% of the adult population in the United States, with the presence of gallstones increasing with age 2.
Prevalence and Risk Factors
- The prevalence of cholelithiasis is estimated to be around 10-20% of the general adult population, with a higher risk of gallstone formation in certain individuals 2, 3.
- Risk factors for cholelithiasis include obesity, diabetes mellitus, estrogen and pregnancy, hemolytic diseases, and cirrhosis 2.
- The female-to-male ratio for cholelithiasis is approximately 4:1 during the reproductive years, narrowing to near equality in older populations 2.
Complications and Management
- Cholelithiasis can lead to various complications, including biliary colic, acute cholecystitis, choledocholithiasis, acute pancreatitis, and cholangitis 4.
- Management strategies for cholelithiasis range from conservative management with pharmacotherapy and bile acid dissolution agents to interventional procedures like extracorporeal shock wave lithotripsy (ESWL) and percutaneous cholecystostomy 4.
- Surgical management, particularly laparoscopic cholecystectomy, remains the gold standard for definitive treatment of cholelithiasis 2, 3, 4.