Cholesterol Gallstones: Causes, Symptoms & Treatment

Cholesterol gallstones account for 80% of all gallstones. They form when bile contains too much cholesterol that bile salts cannot dissolve, combined with reduced gallbladder emptying causing bile stasis. Appearance: yellow-green to pale yellow, round or oval, variable size, may float on bile. The 4 Fs risk factors: Female, Fat, Forty, Fertile. Additional risks: rapid weight loss, bariatric surgery, diabetes, prolonged fasting, TPN, certain medications (fibrates, octreotide), family history. Symptoms: biliary colic (sudden severe right upper pain after fatty meals, lasting 1-5 hours, with nausea); complications include cholecystitis, CBD stones, cholangitis, pancreatitis. Treatment: laparoscopic cholecystectomy (gold standard — permanent cure); UDCA (30-40% success, 50% recurrence, rarely used); watchful waiting for asymptomatic stones. Diagnosis: abdominal ultrasound.