Gallstones and Laparoscopic Cholecystectomy

APPROXIMATELY 10% to 15% of the adult population or more than 20 million people in the United States have gallstones. It is estimated that there are about 1 million newly diagnosed patients annually. The prevalence is higher in women, in association with multiple pregnancies, obesity, and rapid weight loss, as well as in older patients and in certain ethnic groups. In 1991, approximately 600 000 patients underwent cholecystectomy. As a cause of hospitalization, gallstones are the most common and most costly digestive disease, with an annual estimated overall cost of more than $5 billion. In humans, gallstones are composed principally of cholesterol, with pigment stones occurring less commonly. The formation of cholesterol stones is believed to result from the occurrence of cholesterol supersaturation, accelerated cholesterol crystal nucleation, and impaired gallbladder motility. Stones tend to grow for the first 2 to 3 years, at which point growth tends to stabilize; 85%