ABSTRACT
Gallstone disease is one of the most common human afflictions and has been recognized since antiquity. Effective treatment of patients with gallstone-related complications became possible with the introduction of cholecystectomy by Langenbuch in 1882 (1), and in the early 1900s, the development of oral cholecystography made early diagnosis of gallstones possible, thus leading to the expansion of surgical treatment for gallstones. However, despite widespread clinical interest, gallstone pathogenesis remained largely obscure throughout the early 20th century. During the 1960s, many of the physical chemistry principles governing stone formation were elucidated. Shortly following these discoveries, oral dissolution therapy for cholesterol gallstones was introduced (2,3), and the subsequent availability of pharmacologic therapy led to a wave of investigational activities throughout the 1970s and 1980s, leading to the further elucidation of gallstone pathogenesis. These investigations identified multiple pathogenic factors and confirmed the limitations of gallstone dissolution therapy. The introduction of laparoscopic cholecystectomy in the late 1980s prompted the redirection of gallstone therapy toward the surgical removal of the gallbladder.
