Natural History of Gallstones

Abstract

A gallstone is defined as a concrement present in the biliary tract consisting of the gallbladder and bile duct. Gallstone diseases are often encountered in daily clinical practice. In the natural history of gallstones, a follow-up survey for gallstone patients with no treatment showed that the probability of having biliary tract pain during the prospective evaluation was significantly increased in the patients who had a prior history of biliary tract pain compared to those who had no history of pain before. However, the majority of symptomatic gallstone patients do not persist biliary colic for a long time but take a peaceful natural course. In the natural history of asymptomatic gallstones, the incidence rate of severe complications is reportedly a few percent. Among the severe complications, the most frequent one is acute cholecystitis. The conversion rate from asymptomatic to symptomatic gallstone is the highest within a few years after the diagnosis is made, and the rate complications decreases in parallel to the observation period. Moreover, it has been reported that no occurrence of gallbladder cancer is found in the observation period. The corresponding manner for asymptomatic gallstone is generally advised to watch clinical course.