[New aspects in the treatment of cholecysto-and choledolithiasis]

Since gallstone disease is one of the most frequent gastrointestinal disorders (average incidence 27% in males and 47% in females) it is mandatory for practicing physicians to keep abreast of recent progress in therapy. Thus, present treatment is based on the radiologic pattern of radiolucent (cholesterol) and radioopaque (calcium containing) stones. In the young patient, cholecystectomy is recommended for cholecystolithiasis regardless of type of stones, because this procedure is likely in most cases to provide optimal, definitive results at minimal risk. In the elderly, or when the operative risk is aggravated by accompanying disease, an attempt may be made to dissolve cholesterol stones by oral administration of cheno- or ursodeoxycholic acid. Following 18 months to 2 years of medication, the success rate for complete dissolution is approximately 50%.