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Gallstone
| Gallstone | |
|---|---|
| Other names | Gallstone disease, cholelith, cholecystolithiasis (gallstone in the gallbladder), choledocholithiasis (gallstone in a bile duct)[1] |
 | |
| Gallstones typically form in the gallbladder and may result in symptoms if they block the biliary system. | |
| Pronunciation |
|
| Specialty | Gastroenterology General surgery |
| Symptoms | None, crampy pain in the right upper abdomen[2][3][4] |
| Complications | Inflammation of the gallbladder, inflammation of the pancreas, liver inflammation[2][4] |
| Usual onset | After 40 years old[2] |
| Risk factors | Birth control pills, pregnancy, family history, obesity, diabetes, liver disease, rapid weight loss[2] |
| Diagnostic method | Based on symptoms, confirmed by ultrasound[2][4] |
| Prevention | Healthy weight, diet high in fiber, diet low in simple carbohydrates[2] |
| Treatment | Asymptomatic: none,[2] ursodeoxycholic acid (UDCA) and Chenodeoxycholic acid Pain: surgery ERCP, Cholecystectomy[2] |
| Prognosis | Good after surgery[2] |
| Frequency | 10–15% of adults (developed world)[4] |
A gallstone is a stone formed within the gallbladder from precipitated bile components.[2] The term cholelithiasis may refer to the presence of gallstones or to any disease caused by gallstones,[5] and choledocholithiasis refers to the presence of migrated gallstones within bile ducts.
Most people with gallstones (about 80%) are asymptomatic.[2][3] However, when a gallstone obstructs the bile duct and causes acute cholestasis, a reflexive smooth muscle spasm often occurs, resulting in an intense cramp-like visceral pain in the right upper part of the abdomen known as a biliary colic (or "gallbladder attack").[4] This happens in 1–4% of those with gallstones each year.[4] Complications from gallstones may include inflammation of the gallbladder (cholecystitis), inflammation of the pancreas (pancreatitis), obstructive jaundice, and infection in bile ducts (cholangitis).[4][6] Symptoms of these complications may include pain that lasts longer than five hours, fever, yellowish skin, vomiting, dark urine, and pale stools.[2]
Risk factors for gallstones include birth control pills, pregnancy, a family history of gallstones, obesity, diabetes, liver disease, or rapid weight loss.[2] The bile components that form gallstones include cholesterol, bile salts, and bilirubin.[2] Gallstones formed mainly from cholesterol are termed cholesterol stones, and those formed mainly from bilirubin are termed pigment stones.[2][3] Gallstones may be suspected based on symptoms.[4] Diagnosis is then typically confirmed by ultrasound.[2] Complications may be detected using blood tests.[2]
The risk of gallstones may be decreased by maintaining a healthy weight with exercise and a healthy diet.[2] If there are no symptoms, treatment is usually not needed.[2] In those who are having gallbladder attacks, surgery to remove the gallbladder is typically recommended.[2] This can be carried out either through several small incisions or through a single larger incision, usually under general anesthesia.[2] In rare cases when surgery is not possible, medication can be used to dissolve the stones or lithotripsy can be used to break them down.[7]
In developed countries, 10–15% of adults experience gallstones.[4] Gallbladder and biliary-related diseases occurred in about 104 million people (1.6% of people) in 2013 and resulted in 106,000 deaths.[8][9] Gallstones are more common among women than men and occur more commonly after the age of 40.[2] Gallstones occur more frequently among certain ethnic groups than others.[2] For example, 48% of Native Americans experience gallstones, whereas gallstone rates in many parts of Africa are as low as 3%.[10][2] Once the gallbladder is removed, outcomes are generally positive.[2]
- ^ Cite error: The named reference
Qui2013was invoked but never defined (see the help page). - ^ a b c d e f g h i j k l m n o p q r s t u v w x y "Gallstones". NIDDK. November 2013. Archived from the original on 28 July 2016. Retrieved 27 July 2016.
- ^ a b c Lee JY, Keane MG, Pereira S (June 2015). "Diagnosis and treatment of gallstone disease". The Practitioner. 259 (1783): 15–9, 2. PMID 26455113.
- ^ a b c d e f g h i Ansaloni L, Pisano M, Coccolini F, Peitzmann AB, Fingerhut A, Catena F, et al. (2016). "2016 WSES guidelines on acute calculous cholecystitis". World Journal of Emergency Surgery. 11: 25. doi:10.1186/s13017-016-0082-5. PMC 4908702. PMID 27307785.
- ^ Gallstone Disease: Diagnosis and Management of Cholelithiasis, Cholecystitis and Choledocholithiasis. National Institute for Health and Care Excellence: Guidelines. National Institute for Health and Care Excellence (NICE). October 2014. p. 101. PMID 25473723.
- ^ "Complications". nhs.uk. Retrieved 13 May 2018.
- ^ "Treatment for Gallstones". National Institute of Diabetes and Digestive and Kidney Diseases. November 2017.
- ^ Vos T, Barber RM, Bell B, Bertozzi-Villa A, Biryukov S, Bolliger I, et al. (August 2015). "Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 386 (9995): 743–800. doi:10.1016/s0140-6736(15)60692-4. PMC 4561509. PMID 26063472.
- ^ GBD 2013 Mortality and Causes of Death Collaborators (January 2015). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–71. doi:10.1016/s0140-6736(14)61682-2. PMC 4340604. PMID 25530442.
{{cite journal}}:|author1=has generic name (help)CS1 maint: numeric names: authors list (link) - ^ Rosenthal RA, Zenilman ME, Katlic MR, eds. (2011). Principles and practice of geriatric surgery (2nd ed.). Berlin: Springer. p. 944. ISBN 978-1-4419-6999-6. Archived from the original on 2016-08-15.
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