Primary prevention

Patients (with a gallbladder in situ) who have undergone bariatric surgery and are experiencing rapid weight loss are at high risk of gallstones.[26] Others at high risk include those receiving parenteral nutrition and those using somatostatin long-term. 

Primary prevention starts with preventing gallstones, which entails lifestyle modification: a diet high in fiber, low in saturated fat, and maintenance of a normal body weight, coupled with moderate physical activity.[27][28] The evidence for a preventative effect of healthy lifestyle, diet, regular physical activity, and maintenance of an ideal body weight, however, is weak.[29]

Preventative medical therapy employs ursodiol to lower cholesterol saturation in bile and so lessen the short-term risk of stone formation in obese individuals undergoing rapid weight loss through dietary caloric restriction or bariatric surgery.[26]​ Ursodiol has limited value for dissolving established gallstones.[30] This agent is best reserved for the occasional nonsurgical candidate with small gallstones who is truly symptomatic.

Secondary prevention

Patients with symptomatic gallstones should be offered elective cholecystectomy to prevent development of acute cholecystitis.

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