Asymptomatic cholelithiasis and the incidence of gallstone disease

We determined the prevalence of cholelithiasis, by ultrasound in 728 Asian subjects and calculated the annual incidence of disease amongst the gallstone carriers. The prevalence of asymptomatic cholelithiasis in the age group> 29 years, was 11.8% (95% confidence interval: 7.2-16.4%) in males and 13.7% (8.4-19.0%) in females. The median diameter of the stones 10mm (range 4-17) did not differ from that of symptomatic stones - 12.5mm (3·21). The odds of having cholelithiasis increased by 5% each year of life (p 29 years) developing symptoms leading to a hospltal-based investigation was estimated as only 1/1000, whilst the annual cholecystectomy rate was 6/100,000. The chance of a carrier having a cholecystectomy in Malaysia was approximately 5 times less than the chance in the United Kingdom. We conclude that asymptomatic gallstones are common In Malaysians, but the risk of disease is low. The low cholecystectomy rate may be the result of a conservative approach to cholelithiasis due to limited surgical resources.