Pathogenesis and Treatment of Gallstones

Gallstones are a major cause of morbidity and mortality throughout the world. In the United States alone, the diagnosis and treatment of gallstone disease accounted for more than $5 billion in direct costs in 1990, including a half million cholecystectomies1. Progress in the understanding and treatment of gallstones has been rapid during the past decade. The decades-long supremacy of open surgical cholecystectomy as therapy for gallstones has been challenged by gallstone-dissolution techniques and shock-wave lithotripsy and has been overthrown by laparoscopic cholecystectomy. This review will summarize current knowledge of the pathogenesis, diagnosis, and treatment of gallstone disease, with emphasis . . .