ABSTRACT
Gallstones are present in about 8% of men and 17% of women in the United States.1 In obese patients and those losing weight, gallstones are even more common and composed primarily of cholesterol. The pathophysiological conditions involved in cholesterol gallstone formation include biliary cholesterol supersaturation, nucleation of cholesterol crystals, gallbladder dysmotility, genetic predisposition, and enhanced intestinal cholesterol absorption. Recent work has elucidated the pathophysiological changes in obesity that predispose to cholesterol gallstone formation and has provided the possibility of pharmacologic reduction in gallstone risk. This chapter reviews the epidemiology and pathogenesis of cholesterol gallstones, with special attention to obesity, and discusses the effects of weight loss on gallbladder disease.
