RT Book, Section A1 Paumgartner, Gustav A1 Greenberger, Norton J. A2 Greenberger, Norton J. A2 Blumberg, Richard S. A2 Burakoff, Robert SR Print(0) ID 55962112 T1 Chapter 53. Gallstone Disease T2 CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 2e YR 2012 FD 2012 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-176848-1 LK accessmedicine.mhmedical.com/content.aspx?aid=55962112 RD 2021/04/23 AB Major risk factors for cholesterol gallstones include age >50 years, female sex, Mexican or Native American ethnicity, genetic predisposition, family history, pregnancy and parity, estrogens, obesity, and the metabolic syndrome.Gallstones are often found incidentally during abdominal ultrasonography, which has >95% sensitivity for cholesterol stones ≥1.5 mm.In ∼80% of cases gallstones remain asymptomatic; in symptomatic patients, biliary colic is almost always present, often radiating to the right scapula or shoulder.Laparoscopic cholecystectomy is indicated in patients with symptomatic gallstones.Major complications of gallstone disease requiring treatment are acute cholecystitis, choledocholithiasis, obstructive jaundice, cholangitis, and pancreatitis.Acute cholangitis caused by an obstructing gallstone should be treated by endoscopic removal of the stone under antibiotic coverage as soon as possible.