Materiały źródłowe

• #1 Gallstones – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gallstones/diagnosis-treatment/drc-20354220

  Most people with gallstones that don’t cause symptoms will never need treatment. Your doctor will determine if treatment for gallstones is indicated based on your symptoms and the results of diagnostic testing. […] Your doctor may recommend that you be alert for symptoms of gallstone complications, such as intensifying pain in your upper right abdomen. If gallstone signs and symptoms occur in the future, you can have treatment. […] Treatment options for gallstones include: […] Surgery to remove the gallbladder (cholecystectomy). Your doctor may recommend surgery to remove your gallbladder, since gallstones frequently recur. Once your gallbladder is removed, bile flows directly from your liver into your small intestine, rather than being stored in your gallbladder. […] You don’t need your gallbladder to live, and gallbladder removal doesn’t affect your ability to digest food, but it can cause diarrhea, which is usually temporary.

• #1 Surgical and Nonsurgical Management of Gallstones | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0515/p795.html

  Laparoscopic cholecystectomy is the most commonly performed abdominal surgery in industrialized countries, with almost 900,000 procedures performed annually in Europe and the United States. […] Antibiotic prophylaxis is not required in low-risk patients undergoing elective laparoscopic cholecystectomy, but it may reduce the incidence of wound infection in high-risk patients. […] For asymptomatic pigmented or calcified gallstones, no medical therapy aside from pain control is recommended. […] For cholesterol-containing gallstones, litholysis with oral agents is a historical option that is less often used in today’s clinical practice. […] When surgery is to be avoided, extracorporeal shock wave lithotripsy is a noninvasive therapeutic alternative for symptomatic patients. […] As laparoscopic techniques evolve, physicians continue to try to make surgery as minimally invasive as possible.

• #1 Treatment for Gallstones – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/treatment

  If your gallstones are not causing symptoms, you probably dont need treatment. However, if you are having a gallbladder attack or other symptoms, contact your doctor. […] The usual treatment for gallstones is surgery to remove the gallbladder. […] Surgery to remove the gallbladder, called cholecystectomy, is one of the most common operations performed on adults in the United States. […] Surgeons perform two types of cholecystectomy: […] Almost all surgeons perform cholecystectomies with laparoscopy. […] A surgeon performs an open cholecystectomy when your gallbladder is severely inflamed, infected, or scarred from other operations. […] Doctors use nonsurgical treatments for gallstones only in special situations, like if you have cholesterol stones and you have a serious medical condition that prevents surgery.

• #1

  https://www.nhs.uk/conditions/gallstones/treatment/

  Your treatment plan for gallstones depends on how the symptoms are affecting your daily life. […] Treatment may also be recommended if a scan shows high levels of calcium inside your gallbladder, as this can lead to gallbladder cancer in later life. […] If your symptoms are more severe and frequent, surgery to remove the gallbladder is usually recommended. […] If surgery is recommended, you’ll usually have keyhole surgery to remove your gallbladder. This is known as a laparoscopic cholecystectomy. […] After the gallbladder has been removed, the gas in your abdomen escapes through the laparoscope and the cuts are closed with dissolvable stitches and covered with dressings. […] Open surgery is just as effective as laparoscopic surgery, but it does have a longer recovery time and causes more visible scarring.

• #1 Gallbladder – gallstones and surgery | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/gallbladder-gallstones-and-surgery

  Around 80% of people with gallstone symptoms will need surgery. […] Techniques to remove the gallbladder include: laparoscopic cholecystectomy, keyhole surgery, and open surgery (laparotomy). […] After a gallbladder operation, you can expect to: feel mild pain in your shoulder from the carbon dioxide gas, receive pain-relieving medications, be encouraged to cough regularly to clear your lungs from the general anaesthetic, be encouraged to walk around as soon as you feel able, stay overnight in hospital, if you had a laparoscopic cholecystectomy, stay up to 8 days in hospital, if you had open surgery. […] Possible complications of cholecystectomy include: internal bleeding, infection, injury to nearby digestive organs, injury to the bile duct, leakage of bile into the abdominal cavity, injury to blood vessels. […] Most people recover within one week of laparoscopic surgery.

• #1 Gallstones Diagnosis, Tests, & Treatments

  https://www.webmd.com/digestive-disorders/understanding-gallstones-treatment

  While the gallbladder serves an important function, it is not essential for a normal, healthy life. When gallstones are persistently troublesome, doctors often recommend removing the organ entirely. This operation is considered among the safest of all surgical procedures. Each year approximately 750,000 Americans have their gallbladder removed. It is also the only treatment method that eliminates the possibility that other gallstones will develop in the future. […] Today, however, the most commonly used surgical technique is a much simpler approach known as laparoscopic cholecystectomy. The doctor makes several small incisions in the abdomen and then uses special pencil-thin instruments to remove the gallbladder. […] Laparoscopic surgery is highly effective and very safe. It has reduced the hospital stay to a day or two. Patients report less pain and are generally able to resume a normal lifestyle in a short period of time. However, people who are obese or who have a severe infection or inflammation in the gallbladder may still be considered candidates for traditional open surgery.

• #1 Advanced treatment for gallstones is offered at Melbourne Gallbladder Centre – Melbourne Gallbladder Centre

  https://www.melbournegallbladdercentre.com.au/treatment-for-gallstones.html

  Treatment for Gallstones Gallstones are best treated by an operation that removes the gallbladder. This is called a cholecystectomy. The traditional method of cholecystectomy was by open surgery through a long cut under the right edge of the rib cage. Today, most cholecystectomies can be performed by the laparoscopic method (also called key hole surgery). If the gallbladder is causing symptoms or if multiple small stones that can escape into the bile duct are present, then removal of the gallbladder is advised. The surgery, when performed, entails removal of the whole gallbladder with the stones inside. To remove only the stones could result in them reforming after several years and problems returning. The gallbladder is not a vital organ, and absorption and digestion can continue normally after it is taken out. If you have gallstones and dont remove your gallbladder, you risk infection of the gallbladder (cholecystitis) or bile duct obstruction leading to pancreatitis.

• #1 Gallstones (Cholelithiasis): Symptoms, Causes, and Treatments

  https://www.webmd.com/digestive-disorders/gallstones

  Gallstone Treatment […] You usually dont need treatment if you dont have symptoms, as some small gallstones can pass through your body on their own. But there are ways to reduce the chances of gallbladder complications or to treat a gallbladder attack. […] Most people who get gallstones that block their bile ducts and cause symptoms have their gallbladders taken out. Your body can function fine without a gallbladder as your liver can make bile. […] Your doctor will use one of two procedures to remove your gallbladder: Laparoscopic cholecystectomy. This is the most common surgery for gallstones. The surgeon works through tiny cuts (incisions). They pass a narrow tube called a laparoscope into your belly through a small cut. The tube contains a tiny light and a camera. The doctor will take out your gallbladder through another small cut using special devices. Youll usually go home the same day. […] Open cholecystectomy. Your doctor makes bigger cuts in your belly to remove your gallbladder. Youll stay in the hospital for a few days afterward. Youll need open surgery if you have a bleeding disorder. You may also need it if you have severe gallbladder disease, have a bigger body size, or are in your last trimester of pregnancy. […] For both types of surgery, youll get general anesthesia. This means you wont be awake during the procedure. […] If gallstones are in your bile ducts, your doctor may use ERCP to find and remove them before or during surgery. […] You may not be able to have your gallbladder removed if you have any medical condition that makes surgery unsafe. In those special cases, you may need regular or lifelong treatment to remove or break up gallstones. […] Nonsurgical treatment options for gallstones include: Endoscopic retrograde cholangiopancreatography (ECRP): Your doctor may use this procedure to remove gallstones stuck in your bile ducts. […] Medication. Chenodiol (Chenix) and ursodiol (Actigal) contain chemicals that dissolve small cholesterol gallstones. You may need to take these pills for years to break up the stones, and your gallstones may come back after you stop treatment. This drug treatment may cause mild diarrhea. […] Shock wave lithotripsy: Rarely, your doctor may use shock waves to break up your stones. They may suggest doing this alongside drug treatment with something such as ursodiol.

• #1 Treatment for Gallstones – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/treatment

  A doctor may use the following types of nonsurgical treatments to remove or break up cholesterol gallstones: […] Sometimes doctors use ERCP to remove a gallstone that is stuck in the common bile duct. […] Ursodiol (Actigall) and chenodiol (Chenix) are medicines that contain bile acids that can break up gallstones. […] A doctor can use shock wave lithotripsy to blast gallstones into small pieces.

• #1

  https://www.nhs.uk/conditions/gallstones/treatment/

  Endoscopic retrograde cholangio-pancreatography (ERCP) is a procedure that can be used to remove gallstones from the bile duct. […] If your gallstones are small and don’t contain calcium, it may be possible to take ursodeoxycholic acid tablets to dissolve them. […] Ursodeoxycholic acid tablets may occasionally be used to prevent gallstones if it’s thought you’re at risk of developing them. […] A healthy diet won’t cure gallstones or completely eliminate your symptoms, but it can improve your general health and help control pain caused by gallstones.

• #1 Gallstones – Liver and Gallbladder Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/gallbladder-and-bile-duct-disorders/gallstones

  Most stones in the bile ducts can be removed during ERCP. During this procedure, doctors pass an instrument through the endoscope and use it to cut the sphincter of Oddi (which is where the common bile duct connects to the small intestine)—a procedure called endoscopic sphincterotomy. Sometimes the end of the bile duct is also cut and widened. If the stones do not spill out into the small intestine on their own after the cut is made, a catheter with a small basket at its tip is inserted through the endoscope. It can be used to trap and then pull the stone out of the duct. Cutting the end of the bile duct leaves the opening wide enough to let any future stones pass more easily into the small intestine. Gallstones located in the gallbladder cannot be removed using this technique. […] ERCP with endoscopic sphincterotomy is successful in 90% of people. It is far safer than open abdominal surgery. Fewer than 1% of people die from this procedure, but up to 7% experience complications soon after ERCP with endoscopic sphincterotomy. Such complications include inflammation of the pancreas (pancreatitis), and less commonly bleeding and perforation or infection of the bile ducts. Later on, in some people, the inflamed bile ducts narrow (called strictures). When the ducts narrow, stones are more likely to form in the ducts, causing more blockages in the ducts.

• #1 Lithotripsy | Brown University Health

  https://www.brownhealth.org/centers-services/general-and-gastrointestinal-surgery/about-gallstones/lithotripsy

  Lithotripsy, or shock wave dissolution of gallstones, is a new procedure that uses a highly focused sound wave to break the stones into tiny particles which then pass through the cystic duct to the common duct and into the intestine. […] The procedure, which takes about one hour, is done with general anesthesia or in some cases with mild sedation, and no incision is made. […] The patient takes the medication Actigall before and after surgery to dissolve the gallstone fragments. […] About 10 to 15 percent of patients with symptomatic gallstones are eligible for lithotripsy. […] Some patients experience abdominal pain immediately following lithotripsy, as the stone fragments begin to dissolve. […] The overall treatment is 90 to 95 percent effective. […] After the lithotripsy treatment you need to take Actigall three times per day for about one year to aid in the dissolution of the gallstone fragments. […] You still have a diseased gallbladder, with a 30 to 50 percent estimated chance of gallstone recurrence in 3 to 5 years. […] Lithotripsy is a newly-approved procedure which may not be covered by some insurance companies.

• #1

• #1 Gallstones – Diagnosis and Treatment

  https://www.radiologyinfo.org/en/info/gallstones

  Cholecystostomy tube placement: A cholecystostomy tube is a small plastic tube (catheter) placed into your gallbladder through a small incision in the skin. The aim of this procedure is to decompress the distended, blocked and inflamed gallbladder by emptying out the backed up, under pressure bile in your gallbladder and diverting it outside the body into a bag attached to the tube.

• #1 Gallstones – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gallstones/diagnosis-treatment/drc-20354220

  Medications to dissolve gallstones. Medications you take by mouth may help dissolve gallstones. But it may take months or years of treatment to dissolve your gallstones in this way, and gallstones will likely form again if treatment is stopped. […] Sometimes medications don’t work. Medications for gallstones aren’t commonly used and are reserved for people who can’t undergo surgery.

• #1 Ursodiol: MedlinePlus Drug InformationLock

  https://medlineplus.gov/druginfo/meds/a699047.html

  Ursodiol is used to dissolve gallstones in people who do not want surgery or cannot have surgery to remove gallstones. […] Ursodiol is also used to prevent the formation of gallstones in overweight people who are losing weight very quickly. […] Ursodiol is in a class of medications called gallstone dissolution agents. It works by decreasing the production of cholesterol and by dissolving the cholesterol in bile to prevent stone formation and by decreasing toxic levels of bile acids that accumulate in primary biliary cirrhosis. […] This medication must be taken for months to have an effect. If you are taking ursodiol capsules to dissolve gall stones, you may need to take ursodiol for up to 2 years. […] Your gallstones may not completely dissolve, and even if your gallstones do dissolve you may have gallstones again within 5 years after successful treatment with ursodiol. […] Continue to take ursodiol even if you feel well. Do not stop taking ursodiol without talking to your doctor.

• #1 Treatment (medication)

  https://www2.hse.ie/conditions/gallstones/treatment-medication/

  You can take medicine to dissolve your gallstones. But only if your gallstones are small and don’t contain calcium. The medicine is called ursodeoxycholic acid. It’s a tablet. These tablets are not prescribed very often. This is because: […] Ursodeoxycholic acid isn’t usually recommended for pregnant or breastfeeding women. […] Your GP may prescribe these tablets if you’ve recently had weight loss surgery. This is because rapid weight loss can cause gallstones to grow.

• #1 Gallstones Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/gallstones

  Rarely, chemicals are passed into the gallbladder through a catheter. The chemical rapidly dissolves cholesterol stones. This treatment is hard to perform, so it is not done very often. The chemicals used can be toxic, and the gallstones may return. […] Shock wave lithotripsy (ESWL) of the gallbladder has also been used for people who cannot have surgery. This treatment is not used as often as it once was because gallstones often come back. […] The chance of symptoms or complications from gallstone surgery is low. Nearly all people who have their gallbladder taken out by surgery do not have their symptoms return. […] In most people, gallstones can’t be prevented. In people who are obese, avoiding rapid weight loss may help prevent gallstones.

• #1 Gallstones (Cholelithiasis) Treatment & Management: Approach Considerations, Treatment of Asymptomatic Gallstones, Treatment of Patients with Symptomatic Gallstones

  https://emedicine.medscape.com/article/175667-treatment

  Surgical treatment of asymptomatic gallstones without medically complicating diseases is discouraged. The risk of complications arising from interventions is higher than the risk of symptomatic disease. Approximately 25% of patients with asymptomatic gallstones develop symptoms within 10 years. […] However, cholecystectomy for asymptomatic gallstones may be indicated in the following patients: Patients with large gallstones, greater than 2 cm in diameter […] Patients with nonfunctional or calcified (porcelain) gallbladder observed on imaging studies and who are at high risk of gallbladder carcinoma […] Patients with spinal cord injuries or sensory neuropathies affecting the abdomen […] Patients with sickle cell anemia in whom the distinction between painful crisis and cholecystitis may be difficult.

• #1

• #1 Surgical and Nonsurgical Management of Gallstones | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0515/p795.html

  Cholecystectomy, usually laparoscopic, is recommended for most patients with symptomatic gallstones. […] Prophylactic treatment, usually with laparoscopic cholecystectomy, should be recommended for patients with biliary-type symptoms or those with complications of gallstones, because these patients are likely to have recurrent and more severe symptoms. […] For patients with gallstones on imaging but atypical symptoms, other common gastrointestinal diagnoses should be considered, such as peptic ulcer disease, gastroesophageal reflux disease, or irritable bowel syndrome. […] Treatment of acute biliary colic primarily involves pain control with nonsteroidal anti-inflammatory drugs (NSAIDs) or narcotic pain relievers. […] Patients with symptomatic gallstones can be divided into two categories: those who have simple biliary colic and those with complications.

• #1 Management of Gallstones | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0815/p637.html

  Many patients with gallstones can be managed expectantly. Generally, only persons with symptoms related to the presence of gallstones (e.g., steady, nonparoxysmal pain lasting four to six hours located in the upper abdomen) or complications (such as acute cholecystitis or gallstone pancreatitis) warrant surgical intervention. Biliary pain is alleviated by cholecystectomy in the majority of cases. Laparoscopic cholecystectomy is considered the most cost-effective management strategy in the treatment of symptomatic gallstones. […] Patients with biliary pain should have laparoscopic cholecystectomy on first open operative day. […] Patients with acute cholecystitis should have a laparoscopic cholecystectomy early in their management course. This reduces the hospital stay but does not reduce the complication rate compared with delayed surgery.

• #1 Management of Gallstones | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0815/p637.html

  Patients with gallstone pancreatitis should have a laparoscopic cholecystectomy during the same hospitalization. […] Cholecystectomy remains the primary procedure for the management of symptomatic gallstone disease. It is safe, has the lowest risk of recurrence, and provides 92 percent of patients with complete relief of their biliary pain. […] Oral dissolution therapy using bile acids has successfully dissolved gallstones in an extremely limited patient population. […] The current recommendation is for cholecystectomy to be performed during the same hospital admission. […] However, performing cholecystectomy too early in the course of severe gallstone pancreatitis is unwise, and the International Association of Pancreatology recommends waiting for resolution of the pancreatitis and clinical recovery before considering biliary surgery. […] Therefore, it is generally agreed that a more conservative approach is warranted in patients with Child class C cirrhosis and symptomatic gallstone disease, directing treatment toward improving their liver function before cholecystectomy.

• #1 Surgical and Nonsurgical Management of Gallstones | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0515/p795.html

  In pregnant women with symptomatic gallstones, the initial management is supportive care, which is usually successful. […] Although surgery is the treatment of choice for acute cholecystitis, it is associated with increased mortality in older persons. […] Laparoscopic cholecystectomy is the procedure of choice for those with Child-Pugh class A and B cirrhosis.

• #1 New Procedure Removes Gallstones Without Surgery.

  https://www.medstarhealth.org/blog/gallstones-percutaneous-cholangioscopy

  Gallstones are hard deposits of cholesterol, pigmentation, calcium, or bile that can form in the gallbladder, a small organ in the upper abdomen that stores and releases bile as part of the digestive system. Stones can cause life-disrupting symptoms such as abdominal pain, nausea and vomiting, and fever or chills. […] For most gallstones causing symptoms or infection, treatment options are straightforward: […] Medications to help dissolve stones […] Surgery to remove the gallbladder (cholecystectomy) […] In these cases, or for patients living with a gallbladder drain or percutaneous cholecystostomy tube (PCT) that was placed for previous infection, a new procedure is available at MedStar Washington Hospital Center. […] With this procedure called percutaneous cholangioscopy, we can treat the stones without surgically removing the gallbladder.

• #1 New Procedure Removes Gallstones Without Surgery.

  https://www.medstarhealth.org/blog/gallstones-percutaneous-cholangioscopy

  Using the existing gallbladder drain, a camera called a cholangioscope is inserted into the gallbladder without creating a new incision. […] For very large gallstones (larger than 1.5 centimeters), patients can get cutting-edge dual modality lithotripsy a highly effective, nonsurgical treatment that leaves no fragments behind with percutaneous cholangioscopy. […] By combining our specialized training and surgical skills, we can offer patients with complex health problems an effective treatment for large and recurrent gallstones. […] If your doctor determines you are a candidate for this procedure, you will receive anesthesia and pain medication. […] Stones that are less than 1.5cm will be removed using a combination of devices including baskets and lasers. […] For stones larger than 1.5cm, Dr. Marchalik will insert a thin probe called a dual action lithotripsy system into the gallbladder through the cholangioscope.

• #1 New Procedure Removes Gallstones Without Surgery.

  https://www.medstarhealth.org/blog/gallstones-percutaneous-cholangioscopy

  The treatment takes less than two hours, and most patients spend the night in the hospital after the procedure. […] In our research, which was published in the Journal of Interventional and Vascular Radiology, we found that this approach completely removes the gallstones, reducing the risk of recurrent stones. […] All our patients have reported being pain-free and symptom-free after the procedure. […] We are continuing to investigate the benefits of dual modality lithotripsy for gallstones and track our patients outcomes.

• #1 Current Gallstone Treatment Methods, State of the Art

  https://www.mdpi.com/2079-9721/12/9/197

  This study aims to provide valuable references for clinicians in selecting appropriate surgical methods for biliary tract stones based on patient conditions. […] The advantages and disadvantages of various minimally invasive cholelithiasis surgical techniques are systematically summarized and innovative surgical approaches and intelligent stone removal technologies are introduced. […] Among these techniques, PTCS, ERCP, and LCBDE have garnered considerable attention, leading to new surgical techniques; however, it must be acknowledged that each surgical method has its unique indications and potential complications. […] The primary challenge for clinicians is selecting a surgical approach that minimizes patient trauma while reducing the incidence of complications such as pancreatitis and gallbladder cancer and preventing the recurrence of gallstones.

• #1 Current Gallstone Treatment Methods, State of the Art

  https://www.mdpi.com/2079-9721/12/9/197

  For ERCP-based stone extraction, we recommend a small incision of the Oddi sphincter followed by 30 s of balloon dilation as the optimal procedure. […] Artificial intelligence is involved throughout the entire process of gallstone detection, treatment, and prognosis, and more AI-integrated medical technologies are expected to be applied in the future. […] The integration of artificial intelligence with stone extraction surgeries offers new opportunities to address this issue. […] In current practice, ERCP is increasingly being favored over LCBDE for treating gallstones, especially asymptomatic CBD stones. […] This shift may be attributed to the extensive laparoscopic training required for LCBDE, leading to longer training periods and higher costs. […] The advancements in artificial intelligence in recent years have had a significant impact on ERCP.

• #1 How to Get Rid of Gallstones: 9 Natural Treatments

  https://www.healthline.com/health/how-to-get-rid-of-gallstones

  Gallstones are most common in women, people 40 years and older, people with diabetes, people who are obese, pregnant women, people who take hormonal medications, and people who eat high-fat diets. […] A well-balanced diet that includes a variety of fruits and vegetables may help support a healthy gallbladder and reduce your risk for gallstones. […] Talk to your doctor about specific foods you may want to avoid. […] Losing weight can be an important part of preventing gallstones, but the way you lose weight matters. […] Theres little research on the efficacy of natural treatments for gallstones. […] If your doctor has recommended surgery, have an open conversation with them about other options you may be able to try first.

• #1 What to do about gallstones – Harvard Health

  https://www.health.harvard.edu/womens-health/what-to-do-about-gallstones

  You can easily live without a gallbladder. […] If you can’t or don’t want to undergo surgery and your gallstones are small, one option is to take ursodiol (Actigall, Urso), a naturally occurring bile acid that helps dissolve cholesterol stones when taken by mouth two to four times a day. […] Drug therapy is occasionally combined with lithotripsy, in which sound waves from outside the body are used to break gallstones into pieces that dissolve more easily or are small enough to safely pass through the bile duct. […] Unfortunately, stones are likely to recur after medical treatment. […] There’s no proven way to prevent gallstones, but eating a well-balanced diet, maintaining a normal weight, and exercising regularly (at least 30 minutes a day most days of the week).

• #1 Gallstones: Symptoms, diagnosis and treatment – Harvard Health

  https://www.health.harvard.edu/digestive-health/gallstones-symptoms-diagnosis-and-treatment

  Two other ways to break up gallstones include: shockwaves (lithotripsy) to break apart the gallstones so they can pass out of the body on their own and dissolving gallstones with chemicals injected directly into the gallbladder. […] Surgery is strongly preferred over these other treatments because stones are likely to form again if the gallbladder is not removed.

• #2 Treatment for Gallstones – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/treatment

  If your gallstones are not causing symptoms, you probably dont need treatment. However, if you are having a gallbladder attack or other symptoms, contact your doctor. […] The usual treatment for gallstones is surgery to remove the gallbladder. […] Surgery to remove the gallbladder, called cholecystectomy, is one of the most common operations performed on adults in the United States. […] Surgeons perform two types of cholecystectomy: […] Almost all surgeons perform cholecystectomies with laparoscopy. […] A surgeon performs an open cholecystectomy when your gallbladder is severely inflamed, infected, or scarred from other operations. […] Doctors use nonsurgical treatments for gallstones only in special situations, like if you have cholesterol stones and you have a serious medical condition that prevents surgery.

• #2 TREATMENT OF GALLSTONES – WHAT IS THE RIGHT CHOICE

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5531741/

  The choices for elective therapy of gallstones have expanded in the last several decades. […] In symptomatic gallstone patients cholecystectomy remains the treatment of choice and this includes both traditional open and laparoscopic approaches. […] Cholecystectomy is ideal for patients who are willing for surgery. This procedure results in a permanent cure for gallstones with no chance of recurrence (in the gall bladder) and requires no long term follow up or medication. […] The options available for surgical management of gallstones are: Conventional cholecystectomy, Laparoscopic cholecystectomy, Mini-laparotomy with cholecystectomy. […] Laparoscopic cholecystectomy (LC) has become the accepted gold standard for operative management of gallstone disease worldwide. […] Non surgical or medical therapy for cholelithiasis are mainly for patients on whom surgery is contraindicated or in those patients with asymptomatic gallstones who are reluctant to undergo surgery. Options available are: Bile salt therapy, Contact dissolution therapy, Extracorporeal shock wave therapy, Cholecystoscopic evacuation. […] To conclude, gallstone disease has varied therapeutic options ranging from surgery, minimally invasive surgery to nonsurgical treatment in the form of drugs and lithotripsy.

• #2 Gallstones (Cholelithiasis): Symptoms, Causes, and Treatments

  https://www.webmd.com/digestive-disorders/gallstones

  Gallstone Treatment […] You usually dont need treatment if you dont have symptoms, as some small gallstones can pass through your body on their own. But there are ways to reduce the chances of gallbladder complications or to treat a gallbladder attack. […] Most people who get gallstones that block their bile ducts and cause symptoms have their gallbladders taken out. Your body can function fine without a gallbladder as your liver can make bile. […] Your doctor will use one of two procedures to remove your gallbladder: Laparoscopic cholecystectomy. This is the most common surgery for gallstones. The surgeon works through tiny cuts (incisions). They pass a narrow tube called a laparoscope into your belly through a small cut. The tube contains a tiny light and a camera. The doctor will take out your gallbladder through another small cut using special devices. Youll usually go home the same day. […] Open cholecystectomy. Your doctor makes bigger cuts in your belly to remove your gallbladder. Youll stay in the hospital for a few days afterward. Youll need open surgery if you have a bleeding disorder. You may also need it if you have severe gallbladder disease, have a bigger body size, or are in your last trimester of pregnancy. […] For both types of surgery, youll get general anesthesia. This means you wont be awake during the procedure. […] If gallstones are in your bile ducts, your doctor may use ERCP to find and remove them before or during surgery. […] You may not be able to have your gallbladder removed if you have any medical condition that makes surgery unsafe. In those special cases, you may need regular or lifelong treatment to remove or break up gallstones. […] Nonsurgical treatment options for gallstones include: Endoscopic retrograde cholangiopancreatography (ECRP): Your doctor may use this procedure to remove gallstones stuck in your bile ducts. […] Medication. Chenodiol (Chenix) and ursodiol (Actigal) contain chemicals that dissolve small cholesterol gallstones. You may need to take these pills for years to break up the stones, and your gallstones may come back after you stop treatment. This drug treatment may cause mild diarrhea. […] Shock wave lithotripsy: Rarely, your doctor may use shock waves to break up your stones. They may suggest doing this alongside drug treatment with something such as ursodiol.

• #2 Gallstones and their treatment: your questions answered | Top Doctors

  https://www.topdoctors.co.uk/medical-articles/gallstones-and-their-treatment-your-questions-answered

  Gallstones are found in about 10-15% of the population. However, only a minority will have symptoms. One needs operation or interventions only if they are symptomatic. Incidentally detected gallstones can be left unattended as they are unlikely to cause symptoms or complicate in the time to come. […] If one has had symptoms of gallstones or a complication, then an operation to deal with the gall bladder is recommended to avoid further complications; some complications, like pancreatitis and cholangitis, can be serious. […] Gall bladder removal is performed as a day case operation (where you go home on the same day) under general anaesthesia (as such you need to be accompanied home by an adult). This is performed as a keyhole (laparoscopic) operation. There will be four incisions about 1 cm in size.

• #2

  https://www.nhs.uk/conditions/gallstones/treatment/

  Your treatment plan for gallstones depends on how the symptoms are affecting your daily life. […] Treatment may also be recommended if a scan shows high levels of calcium inside your gallbladder, as this can lead to gallbladder cancer in later life. […] If your symptoms are more severe and frequent, surgery to remove the gallbladder is usually recommended. […] If surgery is recommended, you’ll usually have keyhole surgery to remove your gallbladder. This is known as a laparoscopic cholecystectomy. […] After the gallbladder has been removed, the gas in your abdomen escapes through the laparoscope and the cuts are closed with dissolvable stitches and covered with dressings. […] Open surgery is just as effective as laparoscopic surgery, but it does have a longer recovery time and causes more visible scarring.

• #2 Gallstones | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/gallstones/

  In these circumstances, an open cholecystectomy may be recommended. […] An endoscopic retrograde cholangio-pancreatography (ERCP) is a procedure that can be used to remove gallstones from the bile duct. […] If your gallstones are small and don’t contain calcium, it may be possible to take ursodeoxycholic acid tablets to dissolve them. […] However, these aren’t prescribed very often because: […] The use of ursodeoxycholic acid isn’t usually recommended for pregnant or breastfeeding women. […] If you have additional risk factors, such as a family history of gallbladder cancer or high levels of calcium inside your gallbladder, it may be recommended that your gallbladder be removed as a precaution, even if your gallstones aren’t causing any symptoms.

• #2

  https://www.singhealth.com.sg/patient-care/conditions-treatments/gallstones

  Occasionally an X-ray, called a cholangiogram, may be performed during the operation to check for any stones in the bile duct or to visualize the anatomy of the bile duct. […] If there are one or more stones in the bile duct, the surgeon may remove them during the surgery itself or he may choose to have them removed later through an endoscopic procedure called ERCP, or he may convert to an open operation in order to remove all the stones during the operation. […] This is a safe operation with very low complication rates. The risks of surgery include wound infection, bleeding and rarely blood clots in the legs or lungs. […] The risks specific to cholecystectomy are as follows: Small risk (less than 1%) of an injury to the bile duct, bowel and/or blood vessels, which may require further operative repair of the injury.

• #2

• #2 Gallstones – Liver and Gallbladder Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/gallbladder-and-bile-duct-disorders/gallstones

  Most stones in the bile ducts can be removed during ERCP. During this procedure, doctors pass an instrument through the endoscope and use it to cut the sphincter of Oddi (which is where the common bile duct connects to the small intestine)—a procedure called endoscopic sphincterotomy. Sometimes the end of the bile duct is also cut and widened. If the stones do not spill out into the small intestine on their own after the cut is made, a catheter with a small basket at its tip is inserted through the endoscope. It can be used to trap and then pull the stone out of the duct. Cutting the end of the bile duct leaves the opening wide enough to let any future stones pass more easily into the small intestine. Gallstones located in the gallbladder cannot be removed using this technique. […] ERCP with endoscopic sphincterotomy is successful in 90% of people. It is far safer than open abdominal surgery. Fewer than 1% of people die from this procedure, but up to 7% experience complications soon after ERCP with endoscopic sphincterotomy. Such complications include inflammation of the pancreas (pancreatitis), and less commonly bleeding and perforation or infection of the bile ducts. Later on, in some people, the inflamed bile ducts narrow (called strictures). When the ducts narrow, stones are more likely to form in the ducts, causing more blockages in the ducts.

• #2 Nonsurgical Treatment Options for Gallstones

  https://www.medicinenet.com/nonsurgical_treatment_options_for_gallstones/article.htm

  The treatment of gallstones usually involves surgical removal of the gallbladder […] If people are unable to go through surgery, there are different treatment options. Here are several alternatives to surgery: Medication: In early cases of gallstones, medications such as ursodiol or chenodiol can dissolve some gallstones. They are available as oral bile acid pills. These medications cause thinning of the bile, helping gallstones dissolve. Medication to reduce cholesterol levels in the bile may help dissolve certain types of gallstones, but they are not very effective. These medications usually take years to work and do not prevent a recurrence. […] Extracorporeal shock-wave lithotripsy (ECSWL): ECSWL is a non-surgical treatment that uses shock waves to break down/fragment the gallstones if they are less than 2 cm in diameter.

• #2 Nonsurgical Treatment Options for Gallstones

  https://www.everydayhealth.com/gallbladder/non-surgical-treatments-for-gallstones.aspx

  If you have gallbladder symptoms, surgical treatments are preferred unless you are at high risk, and then drug treatments may be utilized. […] Here are six methods for gallstone removal without surgery: […] In some cases, gallstones can be treated with medicine. […] Certain chemicals, such as ursodiol or chenodiol, which have been shown to dissolve some gallstones, are available in oral bile acid pills. […] This method can only be effective on solitary gallstones that are less than 2 centimeters in diameter, so fewer than 15 percent of patients are eligible for ECSWL. […] This nonsurgical treatment option involves injecting a solvent known as methyl tertiary-butyl ether (MTBE) into the gallbladder to dissolve the gallstones. […] Endoscopic drainage mimics the healthy route of bile from the gallbladder to the small intestine.

• #2 Gallstones – Diagnosis and Treatment

  https://www.radiologyinfo.org/en/info/gallstones

  Cholecystostomy tube placement: A cholecystostomy tube is a small plastic tube (catheter) placed into your gallbladder through a small incision in the skin. The aim of this procedure is to decompress the distended, blocked and inflamed gallbladder by emptying out the backed up, under pressure bile in your gallbladder and diverting it outside the body into a bag attached to the tube.

• #2 Gallstones (Cholelithiasis) Treatment & Management: Approach Considerations, Treatment of Asymptomatic Gallstones, Treatment of Patients with Symptomatic Gallstones

  https://emedicine.medscape.com/article/175667-treatment

  The role of medical management of gallstones has declined in recent years. However, medical therapy may be a useful alternative to cholecystectomy in select patients, particularly in those who are not suitable surgical candidates or who are unwilling to undergo surgery. Medical treatment, beyond pain control, is not initiated in the emergency department. […] Medical treatments for gallstones, used alone or in combination, include the following: Oral bile salt therapy (ursodeoxycholic acid) (particularly for x-ray-negative cholesterol gallstones in patients with normal gallbladder function) […] Medical management is more effective in patients with good gallbladder function who have small stones ( 1 cm) with a high cholesterol content. Bile salt therapy may be required for more than 6 months and has a success rate of less than 50%.

• #2

• #2 Non-Surgical Treatments For Gallstones | Brown University Health

  https://www.lifespan.org/centers-services/general-and-gastrointestinal-surgery/about-gallstones/non-surgical-treatments

  The risks of developing symptoms or complications from gallstones in patients who have no symptoms is on the order of 20% over 20 years. Thus, patients who are older than 40 years of age and have no other indications for gallbladder treatment can be observed. […] However, patients with symptoms or no symptoms in the above mentioned groups should consider treatment. Actigall (Ursodiol) is the primary drug used to dissolve gallstones. […] This drug has almost no side effects but can rarely lead to increases in cholesterol or diarrhea. […] Actigall is taken two to three times per day and costs about $2.00 per pill. […] Patients with cholesterol gallstones who take Actigall for two years have a 20% chance of having their gallstones dissolved. […] These patients need to continue taking Actigall once per day after the stones dissolve since their gallbladder remains diseased and there is a 30 to 50% chance of recurrence of gallstones in 3 to 5 years without further treatment.

• #2 Ursodiol: MedlinePlus Drug InformationLock

  https://medlineplus.gov/druginfo/meds/a699047.html

  Ursodiol is used to dissolve gallstones in people who do not want surgery or cannot have surgery to remove gallstones. […] Ursodiol is also used to prevent the formation of gallstones in overweight people who are losing weight very quickly. […] Ursodiol is in a class of medications called gallstone dissolution agents. It works by decreasing the production of cholesterol and by dissolving the cholesterol in bile to prevent stone formation and by decreasing toxic levels of bile acids that accumulate in primary biliary cirrhosis. […] This medication must be taken for months to have an effect. If you are taking ursodiol capsules to dissolve gall stones, you may need to take ursodiol for up to 2 years. […] Your gallstones may not completely dissolve, and even if your gallstones do dissolve you may have gallstones again within 5 years after successful treatment with ursodiol. […] Continue to take ursodiol even if you feel well. Do not stop taking ursodiol without talking to your doctor.

• #2 Nonsurgical Treatment Options for Gallstones

  https://www.medicinenet.com/nonsurgical_treatment_options_for_gallstones/article.htm

  Methyl tertiary-butyl ether (MTBE) Injection: This nonsurgical treatment involves injecting a solvent called MTBE into the gallbladder to dissolve the gallstones. […] Endoscopic drainage: This treatment involves passing an endoscope (a thin tube attached to a camera and light) through the mouth, down the throat, and into the gallbladder. […] Percutaneous cholecystostomy (PC): This is a nonsurgical treatment option, but its most effective when followed by gallbladder removal. […] Transmural drainage: It involves creating a new track through the stomach into the gallbladder and a metal stent is placed, allowing the gallbladder to drain into the small intestine. […] Acute cholecystostomy, an ultrasound-guided drainage procedure: In patients with acute cholecystitis, cholecystostomy may be performed for those who are unable to undergo surgery.

• #2 Gallstones: Watch and wait, or intervene? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/85/4/323

  Gallstones are common in the United States, affecting an estimated 1 in 7 adults. Fortunately, they are asymptomatic in up to 80% of cases, and current guidelines do not recommend cholecystectomy unless they cause symptoms. Laparoscopic cholecystectomy is the standard treatment for symptomatic gallstones, acute cholecystitis, and gallstone pancreatitis. […] First-line therapy for asymptomatic gallstones is expectant management. […] First-line therapy for symptomatic gallstones is cholecystectomy. […] Laparoscopic cholecystectomy is the standard treatment for symptomatic cholelithiasis. For asymptomatic cholelithasis, the usual approach is expectant management (watch and wait), but prophylactic cholecystectomy may be an option in certain patients at high risk. […] Standard treatment for these patients is expectant management. Cholecystectomy is not recommended for patients with asymptomatic gallstones.

• #2 Gallstones (Cholelithiasis) Treatment & Management: Approach Considerations, Treatment of Asymptomatic Gallstones, Treatment of Patients with Symptomatic Gallstones

  https://emedicine.medscape.com/article/175667-treatment

  Patients with risk factors for complications of gallstones may be offered elective cholecystectomy, even if they have asymptomatic gallstones. […] Patients with a calcified or porcelain gallbladder should consider elective cholecystectomy due to the possibly increased risk of carcinoma (25%). […] Ursodeoxycholic acid (ursodiol) is a gallstone dissolution agent. In humans, long-term administration of ursodeoxycholic acid reduces cholesterol saturation of bile […] In patients with established cholesterol gallstones, treatment with ursodeoxycholic acid at a dose of 8-10 mg/kg/d PO divided bid/tid may result in gradual gallstone dissolution. […] Removal of the gallbladder (cholecystectomy) is generally indicated in patients who have experienced symptoms or complications of gallstones, unless the patient’s age and general health make the risk of surgery prohibitive.

• #2 What to do about gallstones – Harvard Health

  https://www.health.harvard.edu/womens-health/what-to-do-about-gallstones

  Gallstones are one of the most common digestive problems treated in women. […] When they do act up, there are effective ways to address the problem. […] Gallstones cause problems when they block any of the ducts carrying bile from the liver or gallbladder (or digestive enzymes from the pancreas) to the small intestine. […] For recurrent gallbladder attacks, the most effective treatment is surgical removal of the gallbladder, or cholecystectomy. […] This approach has largely been replaced by laparoscopic cholecystectomy, in which the gallbladder is removed with instruments inserted through small incisions in the skin. […] However, there’s a slight risk of injuring the bile ducts, and in a small percent of cases, the surgeon may have to switch to an open surgery with a larger incision because of complications.

• #2 Management of Gallstones | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0815/p637.html

  Many patients with gallstones can be managed expectantly. Generally, only persons with symptoms related to the presence of gallstones (e.g., steady, nonparoxysmal pain lasting four to six hours located in the upper abdomen) or complications (such as acute cholecystitis or gallstone pancreatitis) warrant surgical intervention. Biliary pain is alleviated by cholecystectomy in the majority of cases. Laparoscopic cholecystectomy is considered the most cost-effective management strategy in the treatment of symptomatic gallstones. […] Patients with biliary pain should have laparoscopic cholecystectomy on first open operative day. […] Patients with acute cholecystitis should have a laparoscopic cholecystectomy early in their management course. This reduces the hospital stay but does not reduce the complication rate compared with delayed surgery.

• #2 Gallstones: Watch and wait, or intervene? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/85/4/323

  Laparoscopic cholecystectomy is recommended for patients who can undergo surgery. […] For patients experiencing acute cholecystitis, laparoscopic cholecystectomy within 72 hours is recommended. […] If the patient cannot undergo surgery, percutaneous cholecystotomy or novel endoscopic gallbladder drainage interventions can be used. […] For patients with acute gallstone pancreatitis, conservative management with intravenous isotonic solutions and pain control, followed by laparoscopic cholecystectomy, is recommended.

• #2 Non-Surgical Gallstone Removal – Cholangioscopy Technique

  https://allaeimd.com/non-surgical-gallstone-removal-cholangioscopy/

  Non-Surgical Gallstone Removal […] Endoscopic gallstone removal is typically for patients who are too old or high risk to have traditional gallbladder surgery or who have bile duct stones that cannot be removed in the standard fashion. […] Our specialist has treated a number of patients who are over 80 years old and too sick to undergo surgery. The lower risk profile makes this an ideal procedure for older patients or those with a number of medical issues to undergo surgery. […] Endoscopic and fluoroscopic-guided gallstone removal is highly successful, with complete stone removal from the gallbladder or bile ducts occurring in 80% of cases. […] This is a safe and effective procedure when performed by our experienced interventional radiologist with an understanding of the techniques needed to reduce complications. […] We have successfully treated many patients with complete removal of the gallstones. This has rendered them tube free, which is a huge relief for patients and their family.

• #2 Management of Gallstones | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0815/p637.html

  Patients with gallstone pancreatitis should have a laparoscopic cholecystectomy during the same hospitalization. […] Cholecystectomy remains the primary procedure for the management of symptomatic gallstone disease. It is safe, has the lowest risk of recurrence, and provides 92 percent of patients with complete relief of their biliary pain. […] Oral dissolution therapy using bile acids has successfully dissolved gallstones in an extremely limited patient population. […] The current recommendation is for cholecystectomy to be performed during the same hospital admission. […] However, performing cholecystectomy too early in the course of severe gallstone pancreatitis is unwise, and the International Association of Pancreatology recommends waiting for resolution of the pancreatitis and clinical recovery before considering biliary surgery. […] Therefore, it is generally agreed that a more conservative approach is warranted in patients with Child class C cirrhosis and symptomatic gallstone disease, directing treatment toward improving their liver function before cholecystectomy.

• #2 New Procedure Removes Gallstones Without Surgery.

  https://www.medstarhealth.org/blog/gallstones-percutaneous-cholangioscopy

  Using the existing gallbladder drain, a camera called a cholangioscope is inserted into the gallbladder without creating a new incision. […] For very large gallstones (larger than 1.5 centimeters), patients can get cutting-edge dual modality lithotripsy a highly effective, nonsurgical treatment that leaves no fragments behind with percutaneous cholangioscopy. […] By combining our specialized training and surgical skills, we can offer patients with complex health problems an effective treatment for large and recurrent gallstones. […] If your doctor determines you are a candidate for this procedure, you will receive anesthesia and pain medication. […] Stones that are less than 1.5cm will be removed using a combination of devices including baskets and lasers. […] For stones larger than 1.5cm, Dr. Marchalik will insert a thin probe called a dual action lithotripsy system into the gallbladder through the cholangioscope.

• #2 Current Gallstone Treatment Methods, State of the Art

  https://www.mdpi.com/2079-9721/12/9/197

  For ERCP-based stone extraction, we recommend a small incision of the Oddi sphincter followed by 30 s of balloon dilation as the optimal procedure. […] Artificial intelligence is involved throughout the entire process of gallstone detection, treatment, and prognosis, and more AI-integrated medical technologies are expected to be applied in the future. […] The integration of artificial intelligence with stone extraction surgeries offers new opportunities to address this issue. […] In current practice, ERCP is increasingly being favored over LCBDE for treating gallstones, especially asymptomatic CBD stones. […] This shift may be attributed to the extensive laparoscopic training required for LCBDE, leading to longer training periods and higher costs. […] The advancements in artificial intelligence in recent years have had a significant impact on ERCP.

• #2 How to Get Rid of Gallstones: 9 Natural Treatments

  https://www.healthline.com/health/how-to-get-rid-of-gallstones

  Gallstones are most common in women, people 40 years and older, people with diabetes, people who are obese, pregnant women, people who take hormonal medications, and people who eat high-fat diets. […] A well-balanced diet that includes a variety of fruits and vegetables may help support a healthy gallbladder and reduce your risk for gallstones. […] Talk to your doctor about specific foods you may want to avoid. […] Losing weight can be an important part of preventing gallstones, but the way you lose weight matters. […] Theres little research on the efficacy of natural treatments for gallstones. […] If your doctor has recommended surgery, have an open conversation with them about other options you may be able to try first.

• #2 What to do about gallstones – Harvard Health

  https://www.health.harvard.edu/womens-health/what-to-do-about-gallstones

  You can easily live without a gallbladder. […] If you can’t or don’t want to undergo surgery and your gallstones are small, one option is to take ursodiol (Actigall, Urso), a naturally occurring bile acid that helps dissolve cholesterol stones when taken by mouth two to four times a day. […] Drug therapy is occasionally combined with lithotripsy, in which sound waves from outside the body are used to break gallstones into pieces that dissolve more easily or are small enough to safely pass through the bile duct. […] Unfortunately, stones are likely to recur after medical treatment. […] There’s no proven way to prevent gallstones, but eating a well-balanced diet, maintaining a normal weight, and exercising regularly (at least 30 minutes a day most days of the week).

• #2 Gallstones Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/gallstones

  Most of the time, surgery is not needed unless symptoms begin. However, people planning weight loss surgery may need to have gallstones removed before undergoing the procedure. In general, people who have symptoms will need surgery right away or soon after the stone is found. […] A technique called laparoscopic cholecystectomy is most commonly used. This procedure uses small surgical incisions, which allow for a faster recovery. A patient can often go home from the hospital within 1 day of surgery. […] ERCP and a procedure called a sphincterotomy may be done to find or treat gallstones in the common bile duct. […] Medicines may be given in pill form to dissolve cholesterol gallstones. However, these drugs may take 2 years or longer to work, and the stones may return after treatment ends.

• #2 Gallstones

  https://www.massgeneral.org/condition/gallstones

  Gallstones are lumps of solid material that form in your gallbladder. […] If your gallstones don’t cause any symptoms, you often don’t need treatment. […] Gallstones that do cause symptoms should be treated. The likelihood of recurrent gallstone attacks is high. […] If your symptoms don’t go away, your treatment may include: […] ERCP (endoscopic retrograde cholangiopancreatography). […] Sphincterotomy. […] Gallbladder removal (cholecystectomy). […] Percutaneous drainage/cholecystostomy. […] Oral dissolution therapy. […] Methyl-tert-butyl ether. […] Most people respond very well once their stones are dissolved or taken out. […] If symptoms don’t go away, you will need treatment to remove the gallstones. […] If stones are in your gallbladder, the gallbladder must generally be removed. This is a common surgery.

• #3 Gallstones | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/g/gallstones.html?gclsrc=ds

  Gallbladder removal (cholecystectomy). If stones are in your gallbladder, your gallbladder must be removed. These stones cannot be taken out with ERCP. Gallbladder removal is a common surgery. Your body will work well without your gallbladder. It is not essential for a healthy life. […] Oral dissolution therapy. The stones are dissolved using medicines made from bile acid. But it can take a couple of years to completely dissolve the stones. They also tend to come back when the medicine is stopped. […] Most people respond very well once their stones are dissolved or taken out.

• #3 Treatment (procedures)

  https://www2.hse.ie/conditions/gallstones/treatment-procedures/

  Your surgeon may also carry out an X-ray or ultrasound scan of the bile duct. They’ll do this if they think there might be gallstones in there. If they find gallstones they may remove them. […] You may have to have open surgery if keyhole surgery isn’t possible. […] If this is the case, you may have open surgery to remove the gallbladder. The medical name for this is an open cholecystectomy. […] Open surgery is as effective as keyhole surgery. It does have a longer recovery time. It causes more visible scarring. […] This is a procedure to remove gallstones from the bile duct. […] The gallbladder isn’t removed during this procedure. […] Your surgeon will widen the opening of the bile duct. They’ll do this either with a small cut or a heated wire. The bile duct stones are then removed or left to pass into your intestine and out of your body.

• #3 Gallstones (Cholelithiasis) Treatment & Management: Approach Considerations, Treatment of Asymptomatic Gallstones, Treatment of Patients with Symptomatic Gallstones

  https://emedicine.medscape.com/article/175667-treatment

  In patients with gallbladder stones who are suspected to have concurrent common bile duct stones, the surgeon can perform intraoperative cholangiography at the time of cholecystectomy. […] The first cholecystectomy was performed in the late 1800s. The open approach pioneered by Langenbuch remained the standard of care until the late 1980s, when laparoscopic cholecystectomy was introduced. […] Currently, laparoscopic cholecystectomy is commonly performed in an outpatient setting. […] In patients who are critically ill with gallbladder empyema and sepsis, cholecystectomy can be treacherous. In this circumstance, the surgeon may elect to perform cholecystostomy, a minimal procedure involving placement of a drainage tube in the gallbladder. […] If surgical removal of common bile duct stones is not immediately feasible, endoscopic retrograde sphincterotomy can be used. […] Ursodeoxycholic acid treatment can prevent gallstone formation. […] Recommending dietary changes of decreased fat intake is prudent; this may decrease the incidence of biliary colic attacks. However, it has not been shown to cause dissolution of stones.

• #3

  https://www.advocatehealth.com/health-services/digestive-health-center/conditions-we-treat/gallstones

  At Advocate Health Care, our expert team of surgeons and clinicians have access to the latest technology and treatment options to provide the best possible care for gallstones. […] In some cases, medications such as ursodeoxycholic acid and chenodeoxycholic acid can be used to dissolve gallstones, but they may take months or years to work and are not commonly used. They’re often reserved for those who can’t undergo surgery. […] The most commonly used gallstone treatment option is surgery. There are two types of surgeries that can be performed: […] Laparoscopic gallbladder removal: A minimally invasive procedure where surgeons make several small incisions in the abdomen to remove the gallbladder. Recovery time is typically shorter compared to open surgery. […] Open gallbladder surgery: A traditional surgery method where a larger incision is made to remove the gallbladder.

• #3 Gallstones (Cholelithiasis) Treatment & Management: Approach Considerations, Treatment of Asymptomatic Gallstones, Treatment of Patients with Symptomatic Gallstones

  https://emedicine.medscape.com/article/175667-treatment

  Patients with risk factors for complications of gallstones may be offered elective cholecystectomy, even if they have asymptomatic gallstones. […] Patients with a calcified or porcelain gallbladder should consider elective cholecystectomy due to the possibly increased risk of carcinoma (25%). […] Ursodeoxycholic acid (ursodiol) is a gallstone dissolution agent. In humans, long-term administration of ursodeoxycholic acid reduces cholesterol saturation of bile […] In patients with established cholesterol gallstones, treatment with ursodeoxycholic acid at a dose of 8-10 mg/kg/d PO divided bid/tid may result in gradual gallstone dissolution. […] Removal of the gallbladder (cholecystectomy) is generally indicated in patients who have experienced symptoms or complications of gallstones, unless the patient’s age and general health make the risk of surgery prohibitive.

• #3 Gallstones (Cholelithiasis): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/175667-overview

  Cholelithiasis involves the presence of gallstones, which are concretions that form in the biliary tract, usually in the gallbladder. Treatment of gallstones depends on the stage of disease. […] The treatment of gallstones depends upon the stage of the disease, as follows: Lithogenic state Interventions are currently limited to a few special circumstances; Asymptomatic gallstones Expectant management; Symptomatic gallstones Usually, definitive surgical intervention (eg, cholecystectomy), although medical dissolution may be considered in some cases. […] Medical treatments, used individually or in combination, include the following: Oral bile salt therapy (ursodeoxycholic acid); Extracorporeal shockwave lithotripsy. […] Cholecystectomy for asymptomatic gallstones may be indicated in the following patients: Those with large (2 cm) gallstones; Those who have a nonfunctional or calcified (porcelain) gallbladder on imaging studies and are at high risk of gallbladder carcinoma; Those with spinal cord injuries or sensory neuropathies affecting the abdomen; Those with sickle cell anemia in whom the distinction between painful crisis and cholecystitis may be difficult.

• #3 Surgical and Nonsurgical Management of Gallstones | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0515/p795.html

  Cholecystectomy, usually laparoscopic, is recommended for most patients with symptomatic gallstones. […] Prophylactic treatment, usually with laparoscopic cholecystectomy, should be recommended for patients with biliary-type symptoms or those with complications of gallstones, because these patients are likely to have recurrent and more severe symptoms. […] For patients with gallstones on imaging but atypical symptoms, other common gastrointestinal diagnoses should be considered, such as peptic ulcer disease, gastroesophageal reflux disease, or irritable bowel syndrome. […] Treatment of acute biliary colic primarily involves pain control with nonsteroidal anti-inflammatory drugs (NSAIDs) or narcotic pain relievers. […] Patients with symptomatic gallstones can be divided into two categories: those who have simple biliary colic and those with complications.

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