[Changes in silent gallbladder stones. Roentgen-diagnostic and symptomatologic observations over 30 years]

Between 1950 and 1980, a total of 145 patients with pain-free gallstones in the gallbladder and open cystic duct were followed for a mean observation period of 13.5 years. Pigment stones made up 25.5% of the total, cholesterol the rest. Growth of stones was noted in 70% of cases, new stones in 14%, and calcification in 25%. Colics occurred in 29%, severe ulcerative cholecystitis in 4% and passage of stones with pancreatitis in 5.5%. Constant cystic duct occlusion occurred in 18%, causing mild gallbladder inflammation in 40% of them. Cholecystectomy should be limited to large, old stones, to prevent gallstone ileus. Recently formed cholesterol stones should be removed as soon as possible by litholysis. Otherwise expectant waiting with regular follow-up is indicated.