Epidemiology, pathogenesis, and treatment of gallstones

During the past year several epidemiologic reports have confirmed a number of long-held clinical impressions concerning the importance of various risk factors for gallstone disease. Disappointingly there were no new insights in this area. In the area of pathogenesis, studies have suggested additional pronucleating factors. The most important of these have examined nonprotein factors in bile. Laparoscopic cholecystectomy remains the treatment of choice for cholelithiasis. The course of stone recurrence after medical treatment continues to be defined and supports the opinion that solitary stones and multiple cholesterol gallstones should be viewed as manifestations of different diseases.