Current Aspects of Prognosis, Differential Diagnosis, and Spasmolytic Therapy in Gallstone Disease

Aim: to analyze current aspects of prognosis, differential diagnosis, and spasmolytic therapy in gallstone disease.

Key points. The prevalence of gallstone disease in the Russian Federation remains considerably high. Cholelithiasis is associated with cardiovascular disorders and an increased risk of malignancies, including gastric, hepatic, renal, and gallbladder cancer. Several studies emphasize the correlation between the presence and size of gallbladder polyps and the development of gallbladder carcinoma. The current paradigm of biliary pathology postulates that the combined influence of Lith gene polymorphisms, motility disorders, chronic inflammation, and metabolic factors initiates lithogenesis, which in turn promotes chronic cholecystitis and may contribute to gallbladder carcinogenesis. Abdominal pain predominantly localized in the right upper quadrant is the leading clinical manifestation of biliary dyskinesia, chronic cholecystitis, and cholelithiasis. Spasmolytic therapy is considered appropriate for the relief of biliary pain. Clinical studies have demonstrated that the use of the selective spasmolytic agent mebeverine in patients with biliary tract disorders effectively alleviates right upper quadrant pain, improves functional status of the biliary tract, and indirectly facilitates the elimination of biliary sludge.

Conclusion. Gallstone disease represents a key nosological entity within the biliary continuum, characterized by the sequential development of pathogenetically related disorders of the biliary tract. Management of biliary system disorders should focus on relieving biliary pain, restoring motility of the biliary tract, and normalizing the physico-chemical properties of bile.

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