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Introduction: Gallstones cause significant morbidity worldwide. They are responsible for > 95% of biliary tract diseases. The incidence of gallstones is strikingly high in the native populations of North and South America (60-80%), presumably under the influence of dominant lithogenic genes. In the US, 10-20% of adults have gallstone disease with a strong female predilection.

In the Western countries, gallstones are predominantly cholesterol type. In Asia and Africa, they are mainly pigment type and associated with chronic hemolysis or biliary tract infections.

This composite image shows cholesterol stones on the top and pigment stones on the bottom.
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