Cholelithiasis: Incidental and Symptomatic

A majority of individuals with cholelithiasis have few or no related symptoms. Approximately 2% of the asymptomatic population will develop biliary symptoms each year; only a small proportion of these will initially present with complications of cholelithiasis, such as acute cholecystitis, choledocholithiasis, or pancreatitis. Prophylactic or anticipatory cholecystectomy is not necessary for most gallstone patients provided they are truly asymptomatic. The clinician should evaluate symptoms carefully, however, since not all patients present with typical complaints.