Epidemiology pathogenesis-cholelithiasis

(J Hepatol 2016;65:146; Gastro 2016;151:351)

• Affects ~10% of Western populations, 15–25% of people develop sx over 10–15 y

• Bile = bile salts, phospholipids, cholesterol; ↑ cholesterol saturation in bile + accelerated nucleation + gallbladder hypomotility → gallstones

• Risk factors: ♀; South, Central, Native American; ↑ age (>40 y); obesity, TPN, rapid ↓ wt; dyslipidemia; preg., drugs (OCPs, estrogen, clofibrate, octreotide); ileal dis., genetics

• Statin use ↓ risk of sx gallstones & cholecystectomy (Hepatol Res 2015;45:942)