Gallstones

At the turn of the millennium, significant advances continue to be made int o the epidemiology and pathophysiology of gallstone disease. The NHANES III study, the largest American population-based study of gallstone disease, e stimated that more than 20 million Americans have undergone gallbladder sur gery or currently have gallstones. Insulin resistance may be an independent risk factor for gallstone disease. Cholecystokinin receptors may be respon sible for the altered motility of the gallbladder smooth muscle, and mucin may play an underestimated role as a pronucleating factor. For the first ti me, researchers have been able to directly observe cholesterol crystallizat ion in human bile. Improved understanding of the multiple factors involved in the pathogenesis of gallstone disease should lead to new therapeutic and preventive strategies. Curr Opin Gastroenterol 2000, 16:450-453 (C) 2000 L ippincott Williams & Wilkins, Inc.