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Epidemiology and medical treatment of cholesterol gallstones: recurrence, post-dissolution management and the future

  • R. H. Dowling

Abstract

The results of epidemiological studies, now based mainly on ultrasound screening, tell us that in developed societies the prevalence of gallstones is approximately 10%l .When combined with clinical assessment they also tell us that approximately two-thirds of gallstone carriers are unaware that they have stones2 3. In other words, the majority of gallstones diagnosed in this way are silent or asymptomatic. Indirect support for the concept that ‘the innocent gallstone is not a myth’4 comes from comparisons between prevalence rates for cholelithiasis and cholecystectomy rates in any given community. Even though the frequency with which cholecystectomy is carried out varies considerably from country to country5, and despite the fact that surgical removal of the gallbladder is now the most common abdominal operation performed in Western society6, it is clear that only a minority of gallstone carriers will ever come to surgery. By inference, therefore, the majority of patients with cholelithiasis are either unaware of their stones or have related symptoms which the patient, the doctor (or both) judge to be tolerable.

Keywords

Bile Acid Ursodeoxycholic Acid Gallstone Disease Chenodeoxycholic Acid Cholesterol Gallstone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© MTP Press Limited 1984

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  • R. H. Dowling

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