The topic of gallstone prevention was the subject of a 2-day advisory meeting to assist the leadership of the Digestive Diseases and Nutrition Division of the National Institute of Diabetes and Digestive and Kidney Diseases in assessing promising areas of research. It was held July 29-30,1986 in Bethesda, Maryland.
In introducing the meeting, Chairman Scott Grundy proposed that, for discussion purposes, prevention might be considered as primary, secondary or tertiary prevention. Primary prevention would be inhibition of formation of stones in persons who have not previously had gallstones. It could be most productively focused on subjects at increased risk for gallstone formation, e.g., those with obesity, pregnancy, diseases such as diabetes, hypothyroidism and hyperlipidemia, or during therapy with various drugs or hormones such as estrogens or antilipidemic drugs. Secondary prevention might be considered as the successful management of silent gallstones, e.g., the prevention of their clinical complications by dissolving them, flushing them out of the gallbladder with choleretics or preventing their further growth. Tertiary prevention might be considered as the prevention of gallstone recurrence once chemical dissolution of gallstones had taken place. Primary prevention was the main topic of the meeting, adthough some ideas relevant to secondary and tertiary prevention also emerged.