Gallstone disease natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Gallstones develop in many people without causing symptoms. The chance of symptoms or complications from gallstones is about 20%. Nearly all patients (99%) who have gallbladder surgery do not have their symptoms return.

Natural History, Complications and Prognosis

Asymptomatic stones: 16-26% of patients develop gallstone-related symptoms in 10 years. Prophylactic cholecystectomy not indicated UNLESS increased risk of gallbladder (gb) cancer:

• Pima Indian
• Calcified gb
• gb Polyp >10 mm
• Gallstones >2.5 cm
• Salmonella carrier

Diagrams shown below are courtesy of Wikisurgery.com

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Symptomatic stones

38-50% of patients have pain recurrence/year after 1 episode biliary colic. 1-2% of patients have complication rate/year.