Simon Yang, MD, Division of General Surgery, University of Toronto, Toronto, ON.
Calvin Law, MD, MPH, FRCS, Division of General Surgery, University of Toronto; Sunnybrook Health Sciences Centre, Toronto, ON.

The prevalence of gallstones has been increasing among the aging population. Common sequelae of cholelithiasis include asymptomatic gallstones, biliary colic, acute cholecystitis, choledocholithiasis, cholangitis, and gallstone pancreatitis. Among individuals over age 65, gallstone diseases represent an important cause of recurrent abdominal symptoms and surgical admissions. As advanced age is correlated with increased mortality and morbidity in complicated gallstone disease, timely diagnosis and appropriate management are essential to improving disease outcomes.
Key words: older adults, gallstones, cholecystitis, choledocholithiasis.

Bao Q. Tang, MD, FRCS(C), Clinical Fellow, Minimally Invasive Surgery Program, Division of General Surgery, University Health Network, Toronto, ON.
David R. Urbach, MD, MSc, FRCS(C), Assistant Professor of Surgery and Health Policy, Management and Evaluation, University of Toronto; Staff Surgeon, Division of General Surgery, University Health Network, Toronto, ON.

Gallstone disease is common in elderly persons. The clinical syndromes caused by symptomatic gallstones include biliary colic, acute cholecystitis, acute gallstone pancreatitis, choledocholithiasis, cholangitis and gallstone ileus. In most cases, an accurate diagnosis can be made on the basis of the history, physical examination, basic blood tests and abdominal ultrasonography. Cholecystectomy is the appropriate treatment for most patients with symptomatic gallstones, and can be done safely in the elderly. Because the risk of complications of gallstone diseases is higher in the elderly than in younger patients, symptomatic gallstone disease should be identified and treated promptly in elderly persons.
Key words: gallstones, cholecystitis, pancreatitis, cholangitis, cholecystectomy.