Gallstones

Abstract

Lifetime risk of gallstones in Australia is 14%-20%. The most common symptom of gallstones in either the gallbladder or bile duct is epigastric to right upper quadrant pain. Cholecystectomy is indicated for symptomatic gallbladder stones and is usually performed laparoscopically; surgery is rarely indicated for asymptomatic stones. Endoscopic retrograde cholangiopancreatography is indicated for complications of bile duct stones, such as jaundice, cholangitis or severe pancreatitis, and for postcholecystectomy symptoms of stones; bile duct stones may be removed in the same procedure via endoscopic sphincterotomy. Bile duct stones are mostly diagnosed by operative cholangiography at cholecystectomy. Open surgery is used when minimal-access techniques are dangerous, unsuitable or impossible.