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Gallstones and Benign Gallbladder Disease

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Geriatric Gastroenterology

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Abstract

The prevalence of gallstones progressively increases as age advances. Although asymptomatic in most, the clinical manifestations depend on the location of the stone in the biliary system. Gallstones, when in the gallbladder, may be painless or cause a postprandial biliary type of pain in the right upper quadrant related to a meal. When a stone migrates to the cystic duct and causes obstruction, it results in acute cholecystitis. Between 5% and 30% of cholelithiasis patients have concurrent choledocholithiasis. Gallstones obstructing the common bile duct (CBD) cause ascending cholangitis and acute biliary pancreatitis when the stone blocks the ampulla of Vater. Other complications include cholecystoduodenal or choledocho-duodenal fistula and gallstone ileus. Older adults are more likely to present with complications such as acute cholecystitis, gallstone pancreatitis, and common bile-duct stones than the young.

Tokyo guidelines are useful. There is an increase in the number of emergency and elective surgical cases involving older patients. Elective instead of emergency and a laparoscopic approach is the preferred method of surgery. In the management of CBD stones, endoscopic retrograde cholangiography, and stone extraction and stent placement are safe and effective in advanced age groups.

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Authors and Affiliations

  1. Department of Medicine, Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, NJ, USA

    C. S. Pitchumoni

  2. Department of Medicine, New York Medical College, Valhalla, NY, USA

    C. S. Pitchumoni

  3. Division of Gastroenterology, Hepatology and Clinical Nutrition, Saint Peters University Hospital, New Brunswick, NJ, USA

    C. S. Pitchumoni

  4. Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, NY, USA

    Nishal Ravindran

  5. Saint Peters University Hospital, New Brunswick, NY, USA

    Nishal Ravindran

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    C. S. Pitchumoni

  2. Department of Medicine, Division of Geriatrics, Montefiore Medical Center, Wakefield Campus, Bronx, NY, USA

    T.S. Dharmarajan

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Pitchumoni, C.S., Ravindran, N. (2021). Gallstones and Benign Gallbladder Disease. In: Pitchumoni, C.S., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-030-30192-7_54

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