What is the Treatment for Gallstones?

Treatment of gallstones depends partly on whether you are experiencing symptoms or not. If symptoms (especially severe pain) are present, surgical removal of the gallbladder is the most common treatment. If you have no symptoms, you and your doctor may decide that no treatment is needed.

Surgery for Gallstones

An estimated 500,000 Americans have gallbladder surgery each year. I become one of them when my gallbladder was removed in February 2008. This surgery is called a cholecystectomy.

The most common operation for gallbladder removal is called laparoscopic cholecystectomy. The surgeon makes three or four tiny incisions in the abdomen, and then inserts surgical instruments and a miniature video camera into the abdomen. The surgeon uses the camera to see what he is doing, and uses the instruments to remove the gallbladder and gallstones. The surgeon will also inspect the bile ducts and inject a dye to check for any stones or blockages.

If infection or scarring from other surgeries are is found, a surgeon may perform an open surgery instead of the laparoscopic surgery. "Open" surgeries involve the surgeon making a 5- to 8-inch incision in the abdomen to remove the gallbladder. Sometimes a surgeon knows before the surgery that an open surgery will be necessary, and will plan this with the patient. However, a surgeon may encounter a complication after a laparoscopic surgery has begun, and will find it necessary to switch to doing an open surgery instead.

Patients experience less pain, fewer complications, and shorter recovery time with the laparoscopic option than they do after an open surgery. With open surgery, there is more pain, the risk of more complications, and longer hospital stay and recovery time.

Complications of Gallstone Surgery

Injury to one of the bile ducts is the most common complication of gallbladder surgery. If a bile duct is torn, bile can leak into the abdominal cavity, and painful, potentially life-threatening infection can occur. This will require additional surgery. Other complications may be minor, and treatment can be nonsurgical.

Cholecystectomy: During and After

Nonsurgical Treatment for Gallstones

Nonsurgical treatment of gallstones is rarely used, as it can only be used for cholesterol gallstones. If a patient has a serious medical condition that would prevent surgery, a nonsurgical treatment for the gallstones may be attempted. The gallstones, however, usually recur after nonsurgical treatment. The types of nonsurgical gallstone treatment include:

• Oral Dissolution Therapy
  Drugs, ursodiol (Actigall) and chenodiol (Chenix), have been used and work best for small cholesterol stones. These drugs can take months or even years to dissolve the gallstones.

• Contact Dissolution Therapy
  This is an experimental treatment that involves injecting methyl terbutyl ether directly into the gallbladder. This drug can dissolve gallstones in 1 to 3 days. This treatment, however, can be risky because it is a flammable anesthetic, and it can be toxic. As with all treatments, the pros and cons need to be discussed between patient and doctor before proceeding.

For further information on gallstones:

• What Are Gallstones?
• What Causes Gallstones?
• What Are the Symptoms of Gallstones?
• How Are Gallstones Diagnosed?

_{Sources:
"Common Gastrointestinal Problems - Gallstones." American College of Gastroenterology. 9 Sep 2008}

"Gallstones." American College of Gastroenterology. 9 Sep 2008

"Gallstones." NIH Publication No. 07–2897 July 2007. National Digestive Diseases Information Clearinghouse (NDDIC). 9 Sep 2008