Cholelithiasis

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Cholelithiasis is the formation of stones (gallstones) in the gallbladder.

General

  • Often accompanies cholecystitis/contributes and/or causes cholecystitis.
  • The gallbladder is removed following biliary pancreatitis (gallstone pancreatitis) to reduce recurrence risk.[1][2]
  • Gallstones may compress the common bile duct - known as Mirizzi syndrome.[3]
    • Can be associated with jaundice.[4]

The two types of gallstones:

  • Cholesterol stones.
  • Pigment stones.

Note:

  • Most stones technically speaking are a mix, i.e. cholesterol and pigment. Many call yellow stones that are a mix "cholesterol stones".

Epidemiology

Classic risk factors for gallstones - 4 Fs:[5]

  • Female.
  • Fat.
  • Forty.
  • Fertile.

Additional:

  • Family history.

Cholesterol stones

  • More common than pigment stone.

Appearance:

  • Clear or yellow.
  • Opaque or translucent.
  • Sometimes shinny.

Image

Pigment stones

Appearance:

  • Black - key feature.
  • Dull.

Microscopic

  • Not routinely done on gallstones.

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GALLBLADDER CHOLECYSTECTOMY:
- CHOLELITHIASIS.
- MILD CHRONIC CHOLECYSTITIS.

See also

References

  1. Bouwense, SA.; Besselink, MG.; van Brunschot, S.; Bakker, OJ.; van Santvoort, HC.; Schepers, NJ.; Boermeester, MA.; Bollen, TL. et al. (2012). "Pancreatitis of biliary origin, optimal timing of cholecystectomy (PONCHO trial): study protocol for a randomized controlled trial.". Trials 13: 225. doi:10.1186/1745-6215-13-225. PMID 23181667.
  2. van Baal, MC.; Besselink, MG.; Bakker, OJ.; van Santvoort, HC.; Schaapherder, AF.; Nieuwenhuijs, VB.; Gooszen, HG.; van Ramshorst, B. et al. (May 2012). "Timing of cholecystectomy after mild biliary pancreatitis: a systematic review.". Ann Surg 255 (5): 860-6. doi:10.1097/SLA.0b013e3182507646. PMID 22470079.
  3. Khalid, S.; Bhatti, AA.. "Mirizzi's syndrome: an interesting on table finding.". J Ayub Med Coll Abbottabad 26 (4): 621-4. PMID 25672201.
  4. Elhanafy, E.; Atef, E.; El Nakeeb, A.; Hamdy, E.; Elhemaly, M.; Sultan, AM.. "Mirizzi Syndrome: How it could be a challenge.". Hepatogastroenterology 61 (133): 1182-6. PMID 25513064.
  5. Szwed, Z.; Zyciński, P. (2007). "[4F's--still up to date risk factors of cholelithiasis].". Wiad Lek 60 (11-12): 570-3. PMID 18540184.
  6. URL: http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20%28General%20Monographs-%20U%29/URSOFALK.html. Accessed on: 29 October 2011.