Gallstones and Gallbladder Disease - Highlights

Highlights

Risk Factors

• Obesity. Being overweight is a significant risk factor for gallstones. In obese people, the liver over-produces cholesterol, which is delivered into the bile and causes it to become supersaturated. Some evidence suggests that saturated fats and refined sugars are the primary culprits.
• Metabolic syndrome. Metabolic syndrome may be a risk factor for gallstones as well as heart disease. Metabolic syndrome is a cluster of conditions that include high cholesterol, high blood pressure, high blood sugar, and obesity. Obesity itself is also a risk factor for gallstone disease.

Diet

• Fats. Some studies have found a lower risk for gallstones in people who consume foods containing monounsaturated fats (found in olive and canola oils) or omega-3 fatty acids (found in canola, flaxseed, and, particularly, fish oil). Fish oil may be of particular benefit in patients who have high triglyceride levels by improving the emptying actions of the gallbladder.
• Carbohydrates. High intakes of carbohydrates and sugar can increase gallstone risk, suggests a 2005 study in Gut. The researchers recommend that people at risk for gallstones avoid low fat, high carbohydrate diets.
• Nuts. Several recent studies suggest that eating more nuts may reduce the risk of developing gallstones.

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Surgery

Laparoscopic gallbladder surgery is safe for obese people. Laparoscopic cholecystectomy is usually recommended over open cholecystectomy for gallbladder removal. However, some surgeons are concerned that very obese people may not be good candidates for this procedure. A 2005 study indicated that the surgery may take longer to perform in obese people, but it is safe and works well.

A 2006 study found that patients who had undergone previous endoscopic sphincterectomy and those who had abnormally thick gallbladder walls were more likely to have their laparoscopic procedure converted to an open procedure.

Review Date: 06/12/2006
Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital