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Robotic Surgery Virtual Tour

Gallstones - Treatment

Alternative Names

Cholelithiasis

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 allow for a faster recovery. A patient may have their gallbladder removed in the morning and be sent home from the hospital on the same day or the next morning.

MEDICATION

If your gallbladder works properly, 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.

Expectations (prognosis):

Gallstones develop in many people without causing symptoms. The chance of symptoms or complications from gallstones is about 20%. Nearly all patients (99%) who have gallbladder surgery do not have their symptoms return.

Complications:

Calling your health care provider:

Call for an appointment with your health care provider if you have:

Pain in the right upper part of your abdomen
Yellowing of the skin or whites of the eyes

Digestive system

Cholecystolithiasis

Gallstones, cholangiogram

Kidney cyst with gallstones, CT scan

Cholelithiasis

Gallbladder

Gallbladder removal - series

Reviewed last on: 6/3/2008
Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Siddiqui T. Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis of randomized clinical trials. Am J Surg. Jan 2008; 195(1): 40-7.

Chari RS, Shah SA. Biliary System. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery, 18th ed. St. Louis, M0: WB Saunders; 2008: chap. 54.

Diseases of the Gallbladder and Bile Ducts. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap. 159.

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