[Gallstones: natural course and complications].

Cholelithiasis is a common clinical situation. In most individuals it takes an inconspicuous clinical course. In symptomatic patients the complications have to be considered: acute cholecystitis, cholangitis, choledocholithiasis, pancreatitis, ileus by large stones and--in a subgroup of patients--carcinoma of the biliary system. Therapy is warranted in symptomatic patients in order to prevent complications. The decision for use of surgical versus non surgical interventions is decided on a individual basis. In general laparoscopic cholecystectomy is the procedure of choice nowadays. A prophylactic cholecystectomy is as a rule not indicated in asymptomatic patients.