Gallstones. When to observe, when to treat.

Although observation is the best form of therapy for patients with asymptomatic gallstones, surgical management offers the least risk and greatest benefit to patients with symptomatic disease. This is particularly true of patients with diabetes and patients over 60 years of age. Dissolution therapy may play a major role in the treatment of symptomatic cholesterol gallstones in the future, but at present the most effective approach remains early cholecystectomy.