Definition
Gallbladder lithiasis (cholelithiasis) and biliary tract lithiasis (choledocholithiasis) refer to the formation of stones in the gallbladder or bile ducts. The stones are made of cholesterol, bilirubin, or mixed components and can cause inflammation or obstruction.

Pathogenesis
Stone formation is associated with factors such as cholesterol-saturated bile, reduced gallbladder motility, and chronic inflammation. Risk factors include obesity, age, pregnancy, and rapid weight loss.

Diagnosis
Diagnosis is mainly made through abdominal ultrasound, the most common and reliable tool for detecting gallstones. In suspected choledocholithiasis, ERCP, MRCP, or CT scans may be used.

Treatment
Treatment depends on symptom severity and complications:

  • Asymptomatic lithiasis: Usually does not require treatment.
  • Symptomatic lithiasis: Cholecystectomy (surgical removal of the gallbladder) is the treatment of choice.
  • Choledocholithiasis: Treated with ERCP to remove stones from bile ducts.
  • Complications: Such as cholecystitis, cholangitis, or pancreatitis, require immediate medical intervention with medication, drainage, or surgery.

Early diagnosis and appropriate treatment reduce the risk of severe complications such as infections and bile duct obstruction.

Key figures: Pain lasting more than 5 to 6 hours, or accompanied by fever and jaundice, is not simple biliary colic and requires urgent assessment. Asymptomatic stones are monitored rather than operated on.

Besides biliary colic, the most important complication is acute pancreatitis. Painless jaundice should prompt exclusion of bile duct cancer.

Frequently asked questions

Do all gallstones need to be removed?

No. Stones found incidentally without symptoms are generally left alone and simply monitored. Treatment is indicated once they cause symptoms, because the risk of further attacks and complications then rises substantially. The definitive treatment for symptomatic disease is cholecystectomy.

Can diet dissolve gallstones?

No diet dissolves stones. What diet does is reduce how often and how severely attacks occur, mainly by limiting fatty meals that trigger gallbladder contraction. One point is often overlooked: rapid weight loss and very low calorie diets actually increase the risk of forming new stones.

When is a gallstone attack an emergency?

When pain lasts more than 5 to 6 hours, or is accompanied by fever and chills, jaundice, dark urine or persistent vomiting. These suggest cholecystitis, cholangitis or obstruction of the bile duct rather than simple biliary colic, and require urgent assessment.

Sources


Content last updated: September 2026 (14/09/2026).