Pearls and Pitfalls
Cholelithiasis is asymptomatic in most patients.
Abdominal ultrasonography is currently the best diagnostic tool, with a 95% sensitivity for gallstones.
The presence of associated bile duct stones (choledocholithiasis) should be suspected through clinical signs such as jaundice and dark urine (bilirubinuria), together with radiologic and laboratory findings, such as bile duct dilation or increases in serum bilirubin concentration, alkaline phosphatase activity, or aspartate transaminase activity.
In patients with a high suspicion of choledocholithiasis, MR cholangio-pancreatography (MRCP) provides a non-invasive, highly sensitive, diagnostic alternative.
Most patients with asymptomatic cholelithiasis do not require cholecystectomy.
Among symptomatic patients, laparoscopic cholecystectomy is the treatment of choice.
Cholelithiasis is a major risk factor for gallbladder cancer.
Cholelithiasis is the presence of stones in the gallbladder. Gallstones in...