Gallstones

This review summarizes the main advances made in the epidemiology, pathogen esis, and medical treatment of gallstone disease in the past year. Whether rapid weight reduction can precipitate gallstone formation is still debated . Phospholipase A(2)-II seems to play an interesting role in the pathogenes is of multiple cholesterol stone formation, and ursodeoxycholic acid may pa rtially halt the formation of multiple cholesterol stones by mediating an a nti-inflammatory effect on the gallbladder, Bacterial infections may contri bute to gallstone formation, perhaps through secretion of biofilm, The comb ination of ursodeoxycholic acid and simvastatin for the resolution and prev ention of gallstones is promising, but larger studies are needed. (C) 1999 Lippincott Williams & Wilkins, Inc.