Treatment of Gallstones

Treatment of gallstones is decided based on if you have or do not have symptoms. If you have no symptoms, then treatment is not needed. Treatment for people with symptomatic gall bladder disease includes:

• Cholecystectomy (surgical removal of the gallbladder)
• Medications such as ursodeoxycholic acid
• Lithotripsy.

Cholecystectomy

This is usually the most commonly recommended treatment for people with symptomatic gall bladder disease.

Cholecystectomy can be done by two ways:

• Laparoscopic surgery
• Open surgery.

Laparoscopic cholecystectomy: Currently laparoscopic cholecystectomy, is the preferred method for surgical removal of gallbladder. The surgery is done under anaesthesia. In this an instrument with a thin, lighted tube and small camera (laparoscope) is inserted in the abdomen through tiny holes in the abdominal wall.  It allows your doctor to see the organs in your abdomen. The surgeon carefully separates the gallbladder from the nearby structures such as liver, bile ducts and then the gallbladder is removed through the key hole incisions. Laparoscopic surgery has many advantages which includes smaller incision, shorter hospital stay, and less pain. Most people have to stay just for one night in the hospital after surgery and can resume normal activity in a few days.

Open surgery: People with severe inflammation, infection of the gallbladder or scarring from other operations may need open surgery to remove the gallbladder. Recovery from open surgery is longer as compared to laparoscopic surgery and requires 3 to 5 days of hospital stay. Complete recovery to resume normal activity can take a few weeks. Open surgery is performed less often (in about 5 percent of gallbladder operations) than laparoscopic cholecystectomy.

Nonsurgical Treatments

Nonsurgical treatment may be is used for treatment of gallbladder disease in a patient with a serious medical condition which prevents surgery (and who has cholesterol stones). In many cases the stones within 5 years of nonsurgical treatment.

• Ursodeoxycholic acid: Cholesterol gallstones in some patients may be treated with a medication called ursodeoxycholic acid. Prolonged treatment (months to years) may be needed as it slowly dissolves the gallstones. It can cause side effects such as mild diarrhea, nausea and vomiting and itchy skin.
• Lithotripsy: In this treatment ultrasonic shock waves are delivered to the gallstones in order to break them up into tiny pieces. It is not used often as there is about 50% risk of recurrence of symptoms within 5 years of treatment.
• Contact dissolution therapy: This an experimental procedure for treatment of cholesterol stones. The drug—methyl tert-butyl ether—is injected directly into the gallbladder. It takes about 1 to 3 days to dissolve the stone, but it causes irritation and some other complications.