[Cholelithiasis: indications for treatment]

The bases of the current, generally accepted indications for treatment of cholelithiasis are summarized in this article. Asymptomatic gallstones and gallstones with typical symptoms and biliary complications have to be distinguished for an individualized treatment. In asymptomatic cholelithiasis, the formerly recommended prophylactic cholecystectomy has been replaced today by an expectative attitude. Recurrent typical colics require cholecystectomy. Nonsurgical treatments of gallstones are limited to exceptional situations. Gallstones in the bile duct require treatment almost always. They may be removed by surgery or endoscopy. Biliary complications require a rapid intervention.