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Gallstones

Stone types and risk factors, who needs cholecystectomy, biliary colic versus acute cholecystitis (Tokyo 2018 criteria and grading), early surgery versus cholecystostomy, and the complications from duct stones to gallstone ileus and gallbladder cancer.

Tier 1Condition

Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made

3 questions 9 flashcards

At a glance

Gallstones are found in about 10 to 15% of adults in Western populations, and most never cause symptoms.
Asymptomatic stones don't need surgery. Symptomatic stones (colic or a complication) do.
Biliary colic settles within hours. Acute cholecystitis persists, with fever and raised inflammatory markers.

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Sources

Therapeutic Guidelines: Gastrointestinal and Antibiotic (eTG complete), gallstones and acute cholecystitisAU/NZTherapeutic Guidelines Limited
EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol 2016;65:146-181European Association for the Study of the Liver, 2016
Yokoe M et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis. J Hepatobiliary Pancreat Sci 2018;25:41-54Japanese Society of Hepato-Biliary-Pancreatic Surgery, 2018
Pisano M et al. 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis. World J Emerg Surg 2020;15:61World Society of Emergency Surgery, 2020
Loozen CS et al. Laparoscopic cholecystectomy versus percutaneous catheter drainage for acute cholecystitis in high risk patients (CHOCOLATE). BMJ 2018;363:k3965BMJ, 2018
Foley KG et al. Management and follow-up of gallbladder polyps: updated joint guidelines between the ESGAR, EAES, EFISDS and ESGE. Eur Radiol 2022;32:3358-3368European Society of Gastrointestinal and Abdominal Radiology, 2022

Last updated: 14 November 2026

What changed

14 November 2026 Personal emails, About story and Australian-style copy