Diagnosis and Management Cholelithiasis

Abstract

Cholelithiasis (gallstones) are crystals that can be found in the gallbladder, bile ducts, or both. Gallstones are divided into three types, cholesterol stones, pigment stones (bilirubin stones), and mixed stones. Pigment stones are divided into brown pigment and black pigment, and cholesterol stones are the most common type. Cholelithiasis is rare in children but most cases of cholelithiasis in children are associated with several factors, hemolytic disease, history of therapy with Total Parenteral Nutrition (TPN), Wilson's disease, cystic fibrosis, and the use of several types of drugs. The risk factors for cholelithiasis were age >40 years, female gender, overweight, frequent consumption of high-fat foods, low physical activity, and long-term intravenous nutrition. Cholelithiasis can appear with or without symptoms, the clinical symptom that generally appears is biliary colic pain that lasts more than 15 minutes. The progression of cholelithiasis to be symptomatic tends to be low around 10-25%. Cholelithiasis is usually discovered accidentally during an abdominal ultrasound. Supportive examinations for cholelithiasis are laboratory examinations, plain abdominal radiographs, ultrasonography, oral cholecystography, and sonograms. Non-surgical management of cholelithiasis can be in the form of supportive and dietary management, oral dissolution therapy, contact dissolution, and Extracorporeal Shock Wave Lithotripsy (ESWL). Surgical management consists of open cholecystectomy and laparoscopic cholecystectomy. The gold standard for the management of symptomatic cholelithiasis is cholecystectomy.