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1. If the patient has gallstones and is symptomatic, do an elective cholecystectomy because 70% of these patients will have recurrent symptoms if not treated.

2. Do not treat asymptomatic cholelithiasis because only 20% of patients go on to develop symptoms in 10-20 years.

3. Supplemental oral bile acid (ursodeoxycholic acid) may be used in the treatment of gallstones for those who are too ill to have surgery or refuse surgery.


1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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