Epidemiology of Cholesterol Gallstones

GASTROINTESTINAL ENDOSCOPY S165 Gallstones are extremely common in Western societies. Approximately l5% of Americans have gallstones, and approximately 650,000 to 700,000 cholecystectomies are performed every year.1. More than 98% of all biliary tract disorders are in some way related to gallstones. Symptoms and complications related to gallstones are among the most costly digestive disorders, at an estimated annual cost of almost $6.5 billion, exceeding the combined total for chronic liver disease and cirrhosis ($1.6 billion), chronic hepatitis C ($0.8 billion) and diseases of the pancreas ($2.2 billion).2 Stones are most commonly found in the gallbladder, but gallstones can pass through the cystic duct to become intrahepatic or extrahepatic bile duct stones. Ten to fifteen percent of people with gallbladder stones will harbor concomitant common bile duct stones. In some situations, bile duct stones can develop as primary intrahepatic or extrahepatic stones without involving the gallbladder. Primary bile duct concretions are much more common in patients of Asian descent compared with those of European descent. In Western societies, gallstones are composed primarily of cholesterol.