Introduction
gallstones, Gallstone disease, abdominal pain, gallstone, gallstone disease, gastrointestinal disorders
GALLSTONES, ACUTE CHOLECYSTITIS, CHOLANGITIS, GALLSTONE, DISEASE, COMPLICATIONS, CHOLELITHIASIS, ACUTE PANCREATITIS, GALLSTONE DISEASE, POST-CHOLECYSTECTOMY SYNDROME, GASTROINTESTINAL DISORDERS, OBSTRUCTIVE JAUNDICE
Gallstone disease (cholelithiasis) is one of the most common gastrointestinal disorders worldwide, with clinical surveys suggesting prevalence rates of 6% to 25% and a tendency to increase with age.In the UK and North America, the number of surgical procedures for gallstone disease increased steadily between the 1950s and 1990s, reflecting the rise in prevalence and prompt identification of gallstone disease and the use of cholecystectomy as the treatment of choice.The natural course of gallstones is benign; most people remain asymptomatic and show a relatively low progression to symptomatic disease.Most people with symptomatic uncomplicated gallstone disease do not develop complications; reported annual rates of developing complications (eg, acute cholecystitis, acute pancreatitis, acute cholangitis obstructive jaundice) have been as low as 1-3%.Mortality from gallstone disease is rare—typically less than 1% from gallstone related causes.From a patient perspective, the defining symptom of gallstone disease is severe and lasting (ie, >30 minutes) abdominal pain.A recent large prospective study in the UK (n=8909 participants) showed that 10.8% of people experienced complications 30 days after surgery.Post-cholecystectomy syndrome is an umbrella term widely used to describe the range of symptoms patients might experience after surgery.The C-GALL (laparoscopic cholecystectomy versus observation/conservative management for preventing recurrent symptoms and complications in adults with uncomplicated symptomatic gallstones) trial examined the clinical and cost effectiveness of conservative management compared with laparoscopic cholecystectomy to prevent recurrent symptoms and complications in adults with uncomplicated symptomatic gallstone disease.