Litiasis biliar

Abstract

Biliary lithiasis or cholelithiasis is defined as the existence of stones within the gallbladder. It is a common disease. Most cases are asymptomatic and do not require treatment. The typical clinical presentations include biliary colic, choledocholithiasis, cholecystitis, and acute cholangitis. The symptom common to all clinical forms is usually abdominal pain located in the right hypochondrium. Biliary colic and choledocholithiasis typically progress with cholestasis, while cholangitis and acute cholecystitis are also associated with signs of infection such as an increase in acute phase reactants. Clinical, analytical, and radiological parameters are used for diagnosis, with abdominal ultrasound being the most sensitive test for locating the lithiasis. Treatment differs according to the clinical picture. Uncomplicated biliary colic requires analgesia in the acute phase and a scheduled cholecystectomy. Choledocholithiasis requires drainage of the bile duct and, in case of associated acute cholangitis, antibiotic therapy. In acute cholecystitis, an early cholecystectomy as well as antibiotic treatment are indicated.