Cholelithiasis

Question 1

What are gallstones typically made of?

Answer 1

80% are cholesterol

20% are pigment

Question 2

What are the classic risk factors for cholelithiasis?

Answer 2

Fat, fair, female, fertile, 40

Question 3

What are the risk factors for cholesterol stones?

Answer 3

Obesity
Rapid weight loss
Cirrhosis

Question 4

What are the risk factors for pigment stones?

Answer 4

MAle

CHolangitis

Question 5

What are the features of cholelithiasis?

Answer 5

Asymptomatic
Biliary colic- radiation to R shoulder, lasting <6 hours, usually after large/fatty meal
N&V

Question 6

What is choledocholithiasis?

Answer 6

Gallstones in bile duct

Question 7

What are the features of choledocholithiasis?

Answer 7

Obstructive jaundice

Biliary colic >6 hours

Question 8

What investigations are done for cholelithiasis?

Answer 8

US

Bloods- raised LFTs in choledocholithiasis

Question 9

What is the management of asymptomatic gallstones?

Answer 9

Observation

Question 10

What is the management of symptomatic gallstones?

Answer 10

Non op- dissolution, lithotripsy

Op- cholecystectomy

Question 11

What is the management of choledocholithiasis?

Answer 11

ERCP
Lithotripsy
Biliary stenting

Question 12

What are the complications of cholelithiasis?

Answer 12

Acute cholecystitis
Empyema
Perforation
Jaundice
Gallstone ileus