Cholelithiasis (synonyms: calculi biliares; cholecystolithiasis; gallstone; gallstone disease; ICD-10-GM K80.-: Cholelithiasis) is the most common gallstone disease.
A distinction is made according to site of occurrence:
- Cholelithiasis – in the biliary system in general.
- Choledocholithiasis – stones in the common bile duct.
- Cholecystolithiasis – stones in the gallbladder.
By type of gallstones can be distinguished:
- Cholesterol stones – account for about 80% of all stones.
- Pigment stones – circa 20 %, consist of bilirubin, have a rather dark color
- Mixed stones of cholesterol and pigment.
Sex ratio: males to females is 1: 2-3.
Frequency peak: the frequency of the disease increases with age. Gallstones rarely occur before the age of 20.
The prevalence (disease incidence) is 15% in women and 7.5% in men (in Germany). If liver cirrhosis (liver shrinkage) or Crohn’s disease (chronic inflammatory bowel disease (IBD)) is also present, the prevalence is 25-30%. Prevalence increases steadily from the 3rd decade of life with increasing age The disease is commonly found in Western industrialized countries and rarely in East Asia, sub-Saharan Africa, and African Americans.
Course and prognosis: Gallstones cause symptoms in only about 25% of those affected, so their discovery is more likely to be an incidental finding during an abdominal sonography (ultrasound examination of the abdominal organs) performed for other reasons. As long as the gallstones do not cause any symptoms, therapy is not necessary. If repeated biliary colic (seizure-like, severe pain in the right upper abdomen) or, for example, cholecystitis (gallbladder inflammation) occurs, surgical intervention (e.g., minimally invasive laparoscopic cholecystectomy/removal of the gallbladder by laparoscopy) becomes necessary. Gallstones are often recurrent (recurring).
Symptomatic gallstone disease with (“affecting the gallbladder”) symptoms or acute complications (cholecystitis/gallbladder inflammation, cholangitis/bile duct inflammation, pancreatitis/pancreatitis) is possible at any time. The annual risk is reported to be 1-4% (symptoms or 0.1-0.3% (complications.
Comorbidities (concomitant diseases): three large cohort studies confirm that gallstones also increase the risk of coronary heart disease (CHD). It is possible that impaired biliary function may contribute to the increased CHD risk.
