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Pathogenesis, Diagnosis and Treatment of Gallstone Disease A Brief Review

Abstract: Gallstone disease is a gastrointestinal disease that results from the dysfunction of cholesterol, bile, and bilirubin metabolism. Gallstones in the gallbladder are common and form through cholelithiasis. They can also grow in biliary ducts through choledocholithiasis. In industrial countries, gallstone disease has increased in prevalence and affects up to 20% of the adult population. Its major risk factors are female gender, age, obesity, type 2 diabetes, rapid weight loss, physical inactivity, and genetic traits. Various systems for gallstone classification are available. Gallstones are classified as cholesterol, pigmented, and mixed gallstones in accordance with their chemical composition. Gallstone disease is either asymptomatic or has symptoms that manifest as pain in the right upper part of the abdomen, fever, and jaundice. The pathogenesis of this disease is related to the interaction between genetic and environmental factors, which include hepatic cholesterol hypersecretion, bile supersaturation, mucin, inflammatory changes, intestinal hypomotility, intestinal cholesterol hyperabsorption, and gut microbe alterations. The major genetic factors of this disease are the mutations in the hepatic cholesterol transporter ABCC8 and the cholecystokinin a receptor gene. Metabolic syndrome, insulin resistance, and type 2 diabetes increase the risk of developing gallstone disease. The standard diagnostic method for gallstone disease is ultrasound imaging. Medical treatment involves the administration of bile acid drugs and/or cholecystectomy.
Keywords: diabetes / treatment / insulin resistance / gallstone disease / Metabolic syndrome / cholesterol / pathogenesis / obesity

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