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Feature Article

Gallstones: causes, diagnosis and treatment

Thomas J Hugh

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Abstract

Laparoscopic cholecystectomy is the treatment of choice for symptomatic gallstones. It should also be considered for selected patients with asymptomatic gallstones.

Key Points

  • Gallstones are common in Western populations.
  • Risk factors for gallstones include female sex, older age, diabetes and obesity.
  • Typical gallstone symptoms include upper abdominal or right upper quadrant pain (biliary colic), bloating and low-grade nausea.
  • Complications of gallstones include acute cholecystitis, cholangitis and acute pancreatitis.
  • Abdominal ultrasound examination has the highest sensitivity and specificity of any investigation for diagnosing gallstones.
  • Laparoscopic cholecystectomy is a safe, effective treatment for symptomatic gallstones and may be considered for selected patients with asymptomatic gallstones.

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