Gallstones

Alternative Names

Treatment

Modern advances in surgery have revolutionized the treatment of gallstones. In general, surgery is used only if you have symptoms.

In the past, open cholecystectomy (gallbladder removal) was the usual procedure for uncomplicated cases. Today, a minimally-invasive technique called laparoscopic cholecystectomy is most commonly used. This procedure uses smaller surgical cuts, which allows for a faster recovery. A patient may have their gallbladder removed in the morning and be discharged from the hospital on the same evening or the next morning.

MEDICATION

In people with a functioning gallbladder, bile salts taken by mouth may dissolve gallstones. However, the process may take 2 years or longer, and stones may return after treatment ends.

Medicines called chenodeoxycholic acids (CDCA) or ursodeoxycholic acid (UDCA, ursodiol) may be given to dissolve the stones. Both CDCA and UDCA are useful only for gallstones formed from cholesterol.

In some cases, chemicals are passed into the gallbladder through a catheter. The chemical rapidly dissolves cholesterol stones, but potential toxicity, stone recurrence, and other complications limit its usefulness.

LITHOTRIPSY

Electrohydraulic shock wave lithotripsy (ESWL) has also been used to treat gallstones. However, its application is limited if there are a large number of stones present, if the stones are very large, or in the presence of acute cholecystitis or cholangitis. It can also be used in association with UDCA to improve its effect.

Outlook (Prognosis)

Gallstones develop in many people without causing symptoms. The chance of symptoms or complications from gallstones is about 20%. With current surgical approaches, the outlook is excellent for people with symptoms -- over 99% of patients have no recurrence of symptoms.

Possible Complications

• Cholecystitis - acute
• Cholecystitis - chronic
• Cholangitis
• Choledocholithiasis
• Pancreatitis

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have pain in the right upper quadrant of your abdomen, jaundice, or other symptoms of gallstones.