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Uncomplicated gallstone disease in adults

Salam F Zakko, MD, FACP, AGAF
Section Editor
Sanjiv Chopra, MD, MACP
Deputy Editor
Shilpa Grover, MD, MPH, AGAF


Gallstones are common, particularly in Western populations (table 1). In the United States, gallstones are seen in approximately 6 percent of men and 9 percent of women. Most individuals with gallstones are asymptomatic throughout their lives. When the stones start causing symptoms, the condition is referred to as gallstone disease. Uncomplicated gallstone disease refers to stones in the gallbladder that are associated with biliary colic in the absence of complications such as acute cholecystitis, cholangitis, or gallstone pancreatitis.

Determining whether a patient's upper digestive symptoms are the result of gallstones detected on imaging can be challenging. While both gallstones and upper digestive symptoms are common in the general population, they are not always related. Differentiating patients with uncomplicated gallstone disease from those with other disorders and an incidental finding of gallstones is important since cholecystectomy is often curative in those with symptomatic gallstones, but it exposes those with incidental gallstones to unnecessary risk, delays appropriate treatment for the actual cause of symptoms, and incurs unnecessary expense.

This topic will review uncomplicated gallstone disease. The epidemiology of and risk factors for gallstones, the approach to patients with an incidental finding of gallstones, gallstone disease in pregnant women, and the complications of gallstone disease are discussed separately. (See "Epidemiology of and risk factors for gallstones" and "Approach to the patient with incidental gallstones" and "Gallstones in pregnancy" and "Acute cholecystitis: Pathogenesis, clinical features, and diagnosis" and "Etiology of acute pancreatitis", section on 'Gallstones' and "Acute cholangitis" and "Choledocholithiasis: Clinical manifestations, diagnosis, and management".)

The discussion that follows is generally consistent with guidelines from the National Institute for Health and Care Excellence [1].


When considering gallstone disease, we have found it helpful to categorize patients into the following clinical groups:

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Literature review current through: Nov 2017. | This topic last updated: Feb 28, 2017.
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