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Identify patients whose pain is caused by gallstones and offer appropriate surgery. Complications are rare in asymptomatic gallstones, and surgery is not usually recommended. Acute cholecystitis and other complications of cholelithiasis (obstructive jaundice, suppurative cholangitis, empyema or gangrene of the gall bladder, enterobiliary fistula, gallstone ileus) should be treated as soon as possible after the onset of the symptoms . Patients with cholelithiasis often have other illnesses (e.g. peptic ulcer, gastro-oesophageal reflux disease, lactose intolerance, coeliac disease, functional dyspepsia, irritable bowel syndrome, pancreatitis or even cancer). Any symptoms suggestive of the above illnesses usually warrant endoscopic, laboratory or imaging studies before surgery.

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