ASKEP KLIEN DG CHOLELITHIASISNursiswati . over 10% of the adult population of European countries have this disease. In most cases. cholelithiasis is discovered during a routine abdominal ultrasound.• Cholelithiasis. . but also can give symptoms. is a relatively common disease. . • Female gender: the ratio women / men being 2-3/1. • Dyslipidaemia. • Obesity.The main causes incriminated in the development of cholelithiasis are: • Genetic predisposition. • Hypertriglyceridaemia. • Diabetes. • Age. bile acids and lecithin are in a balance that ensures cholesterol solubilisation. the sudden loss weight. obesity) or on the contrary. diabetes.Pathogenesis • Cholelithiasis. with cholesterol crystals development. Biliary stasis is another factor that favors the appearance of gallstones. An increase in the elimination of cholesterol (in dyslipidemia. occurs as a consequence of breaking the existing balance in the bile. . a decrease in bile acid secretion will lead to breaking the balance that ensures cholesterol solubilisation at its precipitation in the gallbladder. where cholesterol. Nausea. vomiting and headache. lasting about 30 minutes. . it is the one that generates biliary colic. occurring in outside of biliary colic. Biliary colic represents a intense or violent pain in the epigastrium or right hypochondrium .Classification of cholelithiasis: A modern concept of cholelithiasis is the classification in: • Symptomatic cholelithiasis. • Asymptomatic cholelithiasis is the form of the disease that does not cause biliary colic. dose not represent symptomatic cholelithiasis. . Acute pancreatitis.Complications of cholelithiasis • • • • • • Biliary colic. Migration of gallbladder stones in coledoc. . Gallbladder cancer. Acute cholecystitis. Vesicular hydrops. consists in bombing of cholesterol stones with shock waves. Chance of success is about 50% and the risk of relapse within 5 years is 10%. up to complete disappearance of all fragments of stones from the gallbladder. Supervision is done by abdominal ultrasound.TREATMENT • Non-surgical treatment techniques of cholelithiasis are drug litholysis and shock wave lithopripsy. Fragments will be dissolved by the administration of bile acids (ursodeoxycholic acid). until the complete dissolution of gallstones apper. • Drug litholysis is addressed to cholesterol gallstones. It is addressed to unique gallstones or less numerous stones. less used lately due to the high degree of occurrence of the relapse. preferably small. . Treatment consists of administration of ursodeoxycholic acid or combined with chenodeoxycholic acid. preferably less than 15 mm. • Shock Wave Lithotripsy. for a period of 3 to 12 months. . . The prognosis of cholelithiasis: • Cholelithiasis has often a good prognosis because symptomatic cases are most often solved by surgery and the asymptomatic forms are kept under surveillance. . THANKS .