[Epidemiology and natural history of biliary calculi. Implication for clinical management]. / Epidemiologia e historia natural de la litiasis biliar. Implicancias para el manejo clinico de la enfermedad.

The knowledge of the epidemiology of cholesterol gallstones is mainly descriptive in Chile. Prevalence data has been gathered from several autopsy studies. The prevalence in these studies is similar to the prevalence determined in a cholecystographic study in a sample of the population of Santiago: 51% of women and 17% of men harbor gallstones, or have been cholecystectomized. The risk factors of the disease are well known and include sex, age, obesity, pregnancy, female sex hormones and hypotriglyceridemic drugs, there is scarce data on the natural history of gallstone disease. In this article we review the present knowledge of both the epidemiology and natural history of gallstones. In addition, we present some specific questions related to the potential identification of environmental and genetic risk factors in epidemiological studies. It is stressed that the knowledge of the natural history of gallstone disease is critical for the appropriate rational management of silent gallstones.

[Symptomatic lithiasic biliary disease. Comparison between men and women undergoing cholecystectomy]. / Enfermedad biliar litiasica sintomatica. Comparacion entre hombres y mujeres sometidos a colecistectomia.

A prospective survey was carried out in 205 males and 667 females who had their gallbladder removed for gallstone disease during 1989 at a general hospital in Chile. Females had a greater prevalence of disease with an earlier appearance of symptoms leading to surgery at a younger age. In contrast, males developed a more aggressive form of the disease, with a shorter interval from appearance of symptoms and surgery.