Gallstone disease and benign biliary occlusions

1. Big picture

Gallstone disease is one of the most common surgical diseases of the biliary tract. The examiner wants you to recognize which gallstone patient can go home, which needs elective laparoscopic cholecystectomy, and which has a life-threatening biliary emergency.

The core surgical pattern is:

Stone in gallbladder → biliary colic or acute cholecystitis
Stone in common bile duct → obstructive jaundice / cholangitis / pancreatitis
Stone compressing common hepatic duct → Mirizzi syndrome
Benign stricture → chronic obstructive jaundice ± cholangitis

Most gallstones are asymptomatic. Surgery is mainly indicated when stones become **symptomatic or complicat