[Epidemiology and gallstones]

Gallstones are more frequent in women than in men due to pregnancy. Increasing age, familial history of the disease, unhealthy lifestyle, overweight, dyslipidemia, type 2 diabetes and high plasma insulin levels are all associated with gallstones. Few asymptomatic stones develop complications. Asymptomatic gallstones should not be treated, but there are difficulties in delimiting the symptoms that are specific to gallstones, and persistent pain after cholecystectomy is frequent. The introduction of laparoscopic cholecystectomy has led to an increase in the cholecystectomy rate and greater regional variation.