Can gallstones be removed without removing the gallbladder. What are the nonsurgical treatment options for gallstones. How effective are these alternatives to gallbladder surgery. When is surgery necessary for gallstone treatment.

Understanding Gallstones and Their Impact on Health

Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. While many people with gallstones don’t experience symptoms, others may suffer from severe pain and complications. Understanding the nature of gallstones is crucial for determining the most appropriate treatment approach.

Gallstones can vary in size from as small as a grain of sand to as large as a golf ball. They’re typically made up of cholesterol or bilirubin, a waste product produced when your body breaks down red blood cells. The formation of gallstones is often linked to an imbalance in the substances that make up bile, the digestive fluid produced by the liver and stored in the gallbladder.

Common Symptoms of Gallstones

• Sudden and intense abdominal pain, often in the upper right portion of the abdomen
• Pain that radiates to the right shoulder or between the shoulder blades
• Nausea or vomiting
• Fever or chills
• Jaundice (yellowing of the skin and eyes)

It’s important to note that many people with gallstones remain asymptomatic. In such cases, the condition is often discovered incidentally during medical imaging for other reasons.

Nonsurgical Approaches to Gallstone Management

While surgery is often recommended for symptomatic gallstones, there are several nonsurgical options available for managing the condition. These alternatives may be suitable for patients who are not ideal candidates for surgery or those who prefer to avoid invasive procedures.

Watchful Waiting: A Conservative Approach

For individuals with asymptomatic gallstones, watchful waiting is often the recommended course of action. This approach involves regular monitoring without immediate intervention. The NHS advises that patients under active monitoring should inform their GP if they notice any symptoms developing.

How effective is watchful waiting for gallstone management? Studies have shown that many people with asymptomatic gallstones never develop symptoms or complications. In fact, the longer a person goes without symptoms, the less likely it is that their condition will worsen.

Dietary Modifications for Gallstone Management

Making changes to your diet can help manage gallstone symptoms and potentially prevent the formation of new stones. A gallstone-friendly diet typically involves:

• Reducing intake of saturated fats and cholesterol
• Increasing fiber consumption
• Maintaining a healthy weight
• Eating regular meals to promote gallbladder emptying

Can dietary changes alone dissolve existing gallstones? While diet modifications are unlikely to dissolve existing stones, they can help prevent the formation of new ones and may reduce the frequency and severity of symptoms in some patients.

Medication-Based Treatments for Gallstones

Certain medications can be used to manage gallstones without surgery. These treatments are typically reserved for patients who cannot undergo surgery or have small cholesterol stones.

Ursodeoxycholic Acid: Dissolving Gallstones Medically

Ursodeoxycholic acid, also known as ursodiol, is a medication that can be used to dissolve small cholesterol gallstones. This treatment works by decreasing the production of cholesterol and increasing bile flow, which can help break down existing stones.

How long does it take for ursodeoxycholic acid to dissolve gallstones? The process is gradual and can take several months to years. It’s most effective for stones smaller than 5mm in diameter. However, it’s important to note that this treatment is not suitable for all types of gallstones and has a recurrence rate of about 50% within five years of stopping treatment.

Pain Management Medications

For patients experiencing mild and infrequent gallstone pain, pain management medications may be prescribed. These can include over-the-counter pain relievers like ibuprofen or prescription medications for more severe pain. While these medications don’t treat the underlying cause, they can help manage symptoms and improve quality of life for some patients.

Minimally Invasive Procedures for Gallstone Removal

In some cases, gallstones can be removed without removing the gallbladder through minimally invasive procedures. These techniques are particularly useful for patients with stones in the bile duct or those who are not suitable candidates for traditional surgery.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

ERCP is a procedure that combines endoscopy and X-ray imaging to diagnose and treat problems in the bile and pancreatic ducts. During this procedure, a flexible tube with a camera is inserted through the mouth and into the small intestine. The doctor can then inject a contrast dye into the ducts and use X-ray imaging to locate gallstones.

How are gallstones removed during ERCP? If stones are found in the bile duct, they can often be removed during the same procedure using special tools passed through the endoscope. This technique is particularly useful for clearing stones from the common bile duct without the need for more invasive surgery.

Percutaneous Cholecystostomy

For patients who are too ill to undergo surgery, a percutaneous cholecystostomy may be performed. This procedure involves inserting a tube through the skin into the gallbladder to drain bile and relieve pressure. In some cases, stones can be removed through this tube or dissolved using medication injected directly into the gallbladder.

Is percutaneous cholecystostomy a permanent solution for gallstones? While this procedure can provide immediate relief and may be used as a bridge to surgery in some cases, it’s not typically considered a permanent solution for most patients with gallstones.

Emerging Technologies in Gallstone Treatment

As medical technology advances, new techniques for treating gallstones without surgery are being developed and refined. These emerging technologies offer promising alternatives for patients seeking nonsurgical options.

Extracorporeal Shock Wave Lithotripsy (ESWL)

ESWL uses shock waves to break gallstones into smaller pieces that can pass through the bile ducts. This technique is typically used in combination with medication to dissolve the fragments. While ESWL can be effective for certain types of gallstones, it’s not widely available and is generally reserved for patients who cannot undergo surgery.

Gallstone Dissolution Using Solvents

Research is ongoing into the use of solvents that can be directly injected into the gallbladder to dissolve stones. While this approach shows promise, it’s still largely experimental and not widely available outside of clinical trials.

When Surgery Becomes Necessary: Understanding the Options

While nonsurgical treatments can be effective for some patients, surgery remains the gold standard for treating symptomatic gallstones. Understanding the surgical options can help patients make informed decisions about their treatment.

Laparoscopic Cholecystectomy: The Standard Surgical Approach

Laparoscopic cholecystectomy is the most common surgical procedure for treating gallstones. This minimally invasive technique involves making small incisions in the abdomen and using specialized instruments to remove the gallbladder.

What are the benefits of laparoscopic cholecystectomy? This procedure typically results in less pain, shorter hospital stays, and faster recovery times compared to open surgery. Most patients can go home the same day and return to normal activities within a week or two.

Single-Incision Laparoscopic Cholecystectomy

A newer variation of laparoscopic surgery, single-incision laparoscopic cholecystectomy, involves making only one small incision, typically near the navel. This technique can result in less visible scarring but requires specialized training and may not be suitable for all patients.

Life After Gallbladder Removal: Adjusting to Changes

For patients who ultimately undergo gallbladder removal, understanding what to expect after surgery can help ease the transition to life without a gallbladder.

Dietary Considerations Post-Cholecystectomy

While the gallbladder isn’t essential for digestion, some patients may experience changes in their digestive process after its removal. Common dietary adjustments include:

• Gradually reintroducing fats into the diet
• Eating smaller, more frequent meals
• Avoiding trigger foods that cause discomfort

Do all patients experience digestive changes after gallbladder removal? While some individuals may notice changes in bowel habits or food tolerance, many people can return to their normal diet without significant issues. It’s important to listen to your body and work with your healthcare provider to develop a diet that works for you.

Long-Term Outlook After Gallstone Treatment

Whether treated surgically or nonsurgically, most patients experience significant improvement in their quality of life after gallstone treatment. However, it’s important to maintain a healthy lifestyle to prevent the recurrence of gallstones or other digestive issues.

Regular follow-ups with your healthcare provider, maintaining a balanced diet, and staying physically active can help ensure long-term health and well-being after gallstone treatment.

Preventive Measures: Reducing the Risk of Gallstone Formation

While not all gallstones can be prevented, certain lifestyle choices can help reduce the risk of their formation. Understanding these preventive measures can be beneficial for those who have had gallstones in the past or are at high risk of developing them.

Dietary Strategies for Gallstone Prevention

A diet that supports gallbladder health can play a significant role in preventing gallstone formation. Key dietary strategies include:

• Maintaining a healthy weight through balanced nutrition and portion control
• Increasing fiber intake through whole grains, fruits, and vegetables
• Limiting saturated fats and choosing healthy fats like those found in olive oil and fish
• Staying hydrated to help maintain proper bile composition

Can certain foods actively prevent gallstones? While no single food can guarantee prevention, some studies suggest that moderate coffee consumption and foods high in vitamin C may have protective effects against gallstone formation.

Lifestyle Modifications for Gallstone Prevention

Beyond diet, several lifestyle factors can influence gallstone risk. Consider the following preventive measures:

1. Regular exercise to help maintain a healthy weight and promote proper digestion
2. Avoiding rapid weight loss, as crash diets can increase the risk of gallstone formation
3. Managing underlying health conditions such as diabetes and high cholesterol
4. Limiting alcohol consumption, which can contribute to gallstone formation in some individuals

How effective are these preventive measures? While they can significantly reduce the risk of gallstone formation, it’s important to note that some risk factors, such as age, gender, and genetics, cannot be modified. However, adopting a healthy lifestyle can have numerous benefits beyond gallstone prevention.

The Future of Gallstone Treatment: Advancements on the Horizon

As medical research continues to advance, new approaches to gallstone treatment are being explored. These innovative techniques may offer more effective and less invasive options for patients in the future.

Targeted Drug Therapies

Researchers are investigating new medications that could more effectively dissolve gallstones or prevent their formation. These targeted therapies aim to address the underlying biochemical processes that lead to gallstone development.

What potential advantages do these new drug therapies offer? If successful, these treatments could provide a nonsurgical option for a wider range of patients, potentially reducing the need for gallbladder removal in many cases.

Advanced Imaging and Diagnostic Techniques

Improvements in imaging technology may allow for earlier detection and more precise characterization of gallstones. This could lead to more personalized treatment approaches, with interventions tailored to the specific type and location of gallstones in each patient.

How might advanced imaging change gallstone treatment? More accurate diagnostics could help doctors determine which patients are most likely to benefit from nonsurgical treatments, potentially reducing the number of unnecessary surgeries.

Robotic-Assisted Surgery

While already in use for various procedures, robotic-assisted surgery for gallbladder removal is becoming more refined. This technology allows for greater precision and may further reduce recovery times and complications.

What are the potential benefits of robotic-assisted gallbladder surgery? This technique may offer improved outcomes, particularly for complex cases or patients with anatomical variations that make traditional laparoscopic surgery challenging.

As research in these areas progresses, patients with gallstones may have access to an even wider range of treatment options in the coming years. The goal of these advancements is to provide effective, minimally invasive treatments that can address gallstones while preserving the gallbladder whenever possible.

Gallstones – NHS

Your treatment plan for gallstones depends on how the symptoms are affecting your daily life.

If you don’t have any symptoms, active monitoring is often recommended. This means you won’t receive immediate treatment, but you should let your GP know if you notice any symptoms.

As a general rule, the longer you go without symptoms, the less likely it is that your condition will get worse.

You may need treatment if you have a condition that increases your risk of developing complications, such as:

• scarring of the liver (cirrhosis)
• high blood pressure inside the liver (this is known as portal hypertension and is often a complication of alcohol-related liver disease)
• diabetes

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 you have episodes of abdominal pain (biliary colic), treatment depends on how the pain affects your daily activities.

If the pain is mild and infrequent, you may be prescribed painkillers to control further episodes and be given advice about eating a healthy diet to help control the pain.

If your symptoms are more severe and frequent, surgery to remove the gallbladder is usually recommended.

The gallbladder isn’t an essential organ and you can lead a normal life without one.

Some people may experience symptoms of bloating and diarrhoea after eating fatty or spicy food. If certain foods trigger symptoms, you may wish to avoid them in the future.

Keyhole surgery to remove the gallbladder

If surgery is recommended, you’ll usually have keyhole surgery to remove your gallbladder. This is known as a laparoscopic cholecystectomy.

During a laparoscopic cholecystectomy, 3 or 4 small cuts are made in your abdomen.

One larger cut (about 2 to 3cm) is made by the belly button and the others (each 1cm or less) will be on the right side of your abdomen.

Your abdomen is temporarily inflated using carbon dioxide gas. This is harmless and makes it easier for the surgeon to see your organs.

A laparoscope (a long, thin telescope with a tiny light and video camera at the end) is inserted through one of the cuts in your abdomen.

This allows your surgeon to view the operation on a video monitor. They’ll remove your gallbladder using special surgical instruments.

If it’s thought there may be gallstones in the bile duct, an X-ray or ultrasound scan of the bile duct is also taken during the operation.

If gallstones are found, they may be removed during keyhole surgery. If the operation can’t be done this way, or an unexpected complication occurs, it may have to be converted to open surgery.

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.

Laparoscopic cholecystectomies are usually carried out under a general anaesthetic, which means you’ll be unconscious during the procedure and won’t feel any pain while it’s carried out.

The operation takes 60 to 90 minutes and you can usually go home the same day.

Full recovery typically takes around 10 days.

Single-incision keyhole surgery

Single-incision laparoscopic cholecystectomy is a newer type of keyhole surgery used to remove the gallbladder.

During this type of surgery, only 1 small cut is made, which means you’ll only have a single scar.

But as this type of cholecystectomy hasn’t been carried out as often as conventional cholecystectomies, there are still some uncertainties about it.

Access to single-incision laparoscopic cholecystectomies is also limited because it needs an experienced surgeon with specialist training.

Read more about single-incision laparoscopic cholecystectomy on the National Institute for Health and Care Excellence (NICE) website

Open surgery

A laparoscopic cholecystectomy may not be recommended if you:

• are in the third trimester (the last 3 months) of pregnancy
• are extremely overweight
• have an unusual gallbladder or bile duct structure that makes a keyhole procedure difficult and potentially dangerous

In these circumstances, an open cholecystectomy may be recommended.

A 10 to 15cm (4 to 6in) incision is made in the abdomen, underneath the ribs, so the gallbladder can be removed.

General anaesthetic is used, so you’ll be unconscious and won’t feel any pain.

Open surgery is just as effective as laparoscopic surgery, but it does have a longer recovery time and causes more visible scarring.

Most people have to stay in hospital for up to 5 days. It typically takes 6 weeks to fully recover.

Read more about recovering from gallbladder surgery.

Endoscopic retrograde cholangio-pancreatography (ERCP)

Endoscopic retrograde cholangio-pancreatography (ERCP) is a procedure that can be used to remove gallstones from the bile duct.

The gallbladder isn’t removed during this procedure, so any stones in the gallbladder will remain unless they’re removed using other surgical techniques.

ERCP is similar to a diagnostic cholangiography (see diagnosing gallstones for more information), where an endoscope (a long, thin flexible tube with a camera at the end) is passed through your mouth down to where the bile duct opens into the small intestine.

But during ERCP, the opening of the bile duct is widened with a small cut or an electrically heated wire.

The bile duct stones are then removed or left to pass into your intestine and out of your body.

Sometimes a small tube called a stent is permanently placed in the bile duct to help the bile and stones pass.

ERCP is usually carried out under sedation, which means you’ll be conscious throughout the procedure but won’t experience any pain.

The procedure lasts about 30 minutes on average, but can take from 15 minutes to over an hour.

Afterwards, you may need to stay in hospital overnight so you can be monitored.

Medicine to dissolve gallstones

If your gallstones are small and don’t contain calcium, it may be possible to take ursodeoxycholic acid tablets to dissolve them.

But these aren’t prescribed very often because:

• they’re rarely very effective
• they need to be taken for a long time (up to 2 years)
• you can get gallstones again after treatment is stopped

Side effects of ursodeoxycholic acid are uncommon and are usually mild. The most commonly reported side effects are feeling sick, being sick and itchy skin.

Ursodeoxycholic acid isn’t usually recommended for pregnant or breastfeeding women.

Sexually active women should either use a barrier method of contraception, such as a condom, or a low-dose oestrogen contraceptive pill while taking ursodeoxycholic acid, as it may affect other types of oral contraceptive pills.

Ursodeoxycholic acid tablets may occasionally be used to prevent gallstones if it’s thought you’re at risk of developing them.

For example, ursodeoxycholic acid may be prescribed if you have recently had weight loss surgery, as rapid weight loss can cause gallstones to grow.

Diet and gallstones

In the past, people with gallstones who weren’t suitable for surgery were sometimes advised to adopt a very low-fat diet to stop the gallstones growing.

But recent evidence suggests this isn’t helpful because rapid weight loss resulting from a very low-fat diet can actually cause gallstones to grow.

This means that if surgery isn’t recommended or you want to avoid having an operation, it’s advisable to adopt a healthy, balanced diet based on The Eatwell Guide.

This involves eating a variety of foods, including moderate amounts of fat, and having regular meals.

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.

Read more about healthy eating.

Page last reviewed: 19 November 2021
Next review due: 19 November 2024

Nonsurgical Treatment Options for Gallstones

Have you ever felt a strange aching pain in your upper abdomen? Usually digestive discomfort after a hearty meal isn’t anything to worry about, but for others, it’s a sign of a malfunctioning gallbladder.

Some people with gallstones never exhibit symptoms, while others experience severe pain. If you are experiencing pain in the upper abdomen or right side of the body, you may have gallstones, and will want to seek treatment to avoid further complications. At least in the United States, about 25 percent of newly diagnosed patients with gallstones will need treatment.

The gallbladder’s main function is to store bile, a substance secreted by the liver that helps with digestion. Sometimes bile contents crystallize and form gallstones.

Gallstones, which can be as small as a grain of salt or as large as a golf ball, can cause some serious problems. They can block ducts inside the organ, causing the gallbladder to become inflamed. Even worse, when a gallstone passes out of the gallbladder duct and into the main bile duct, it can lead to a bile duct infection that can ultimately cause inflammation of the pancreas.

Many patients have gallbladder surgery to alleviate pain and to avoid the potentially serious conditions caused by gallstones. In fact, surgery — in this case, a cholecystectomy, or gallbladder removal — is the most common form of treatment for gallstones. But the fact that surgically removing gallstones requires the removal of an entire organ has led to a growing interest in nonsurgical treatments for gallstones.

Why Treatment for Gallstones Is Necessary

Besides alleviating symptoms, treatment for gallstones is necessary to avoid a progression that can result in severe conditions, such as acute cholecystitis, the condition in which the gallstone blocks the gallbladder ducts, causing the gallbladder to become inflamed and infected. Patients with acute cholecystitis are usually hospitalized and receive antibiotics, pain medication, and often surgery.

If you do not have symptoms, the most common treatment is to “wait and see,” because the risks outweigh the benefits for both medical and surgical treatments. If you have gallbladder symptoms, surgical treatments are preferred unless you are at high risk, and then drug treatments may be utilized.

“If someone is symptomatic, we do recommend patients get the gallbladder taken out,” says Nikhil Kumta, MD, an attending gastroenterologist at Mount Sinai Hospital in New York City. “[Gallbladder surgery] is minimally invasive, so the risk of complications is low. But if people are unable to go through surgery, if someone is really old or really sick, there are different treatment options.”

Here are seven alternatives to surgery:

1. Thinning Bile With Acid Pills Can Dissolve Gallstones

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. These medicines work by thinning the bile, which allows gallstones to dissolve.

While these pills can be effective and are generally well tolerated by patients, medical treatment of gallstones is limited to people whose stones are small and made of cholesterol. But according to Mount Sinai, these drugs can take two years or longer to work, and gallstones may return after treatment ends.

“Decreasing the cholesterol content of the bile can dissolve (certain gallstones), but it’s not effective enough that we don’t refer patients to surgery,” Dr. Kumta says.

2. Small Gallstones Can Be Broken Apart With Shock Waves

Another nonsurgical treatment for which gallstones must meet certain criteria is extracorporeal shock-wave lithotripsy (ECSWL). Although it is most commonly used to treat kidney stones, it can also be used on gallstones. The goal of the treatment is to break up, or fragment, gallstones by sending shock waves through the soft tissue of the body.

This method is only effective on solitary gallstones that are less than 2 centimeters in diameter, so fewer than 15 percent of patients are eligible for ECSWL. A case report published in 2017 in the International Journal of Surgery Case Reports found a low success rate for ECSWL patients with multiple gallstones. Even when stones are fragmented, a diseased gallbladder may not expel the fragment.

According to research published in the October-December 2014 issue of the Journal of Indian Association of Pediatric Surgeons, for this form of treatment, children may be the best candidates.

3. Gallstones Can Be Dissolved With an MTBE Injection

This nonsurgical treatment option involves injecting a solvent known as methyl tertiary-butyl ether (MTBE) into the gallbladder to dissolve the gallstones. According to research published in June 2015 in the journal Case Reports in Surgery, MTBE rapidly dissolves gallstones — but there can be some serious side effects, such as severe burning pain. MTBE creates fumes, and if it’s not administered properly in a ventilated area, it could cause severe burning for the patient and operators, and even cause electrical fires. Inquire about your doctor’s level of experience with performing this procedure before getting this form of treatment.

4. Endoscopic Drainage Follows the Gallbladder’s Natural Path

Endoscopic drainage mimics the healthy route of bile from the gallbladder to the small intestine. An endoscopic transpapillary treatment involves accessing the cystic duct with a camera through the mouth and down the throat. Then a wire is placed through the duct into the gallbladder. It is coiled to imitate the trajectory of the bile out of the small intestine, which is the same process as that of a healthy gallbladder. Kumta says that this form of treatment allows the gallbladder to resume normal bile disposal.

5. Percutaneous Cholecystostomy Is Best for Seriously Ill Patients

This is a nonsurgical treatment option, but it’s most effective when followed by gallbladder removal. Percutaneous cholecystostomy (PC) is typically saved for seriously ill patients who cannot tolerate surgery right away. The procedure involves using a needle to withdraw fluid from the gallbladder and then inserting a catheter through the skin to drain the fluid. The catheter is left in place for a number of weeks, after which gallbladder removal surgery is performed to prevent recurrence.

6. Transmural Drainage Decompresses a Swollen Gallbladder

“Transmural drainage creates a new tract directly through the stomach into the gallbladder,” Kumta says. An expandable metal stent is then placed to allow the gallbladder to drain into the small intestine. “This allows the gallbladder to decompress.”

With this approach, a study published in March 2016 in the journal Therapeutic Advances in Gastroenterology found high success rates, with one only 1 out of 16 patients experiencing complications during the stent placement process.

7. Acute Cholecystostomy, an Ultrasound-Guided Drainage Procedure

For patients who have acute cholecystitis or gallbladder inflammation and are unable to have surgery, an endoscopic stent can be placed between the gallbladder and alimentary tract to drain infection in a procedure called acute cholecystoenterostomy (ACE). A meta-analysis published in April 2018 in the journal Surgical Endoscopy found that ACE was just as effective, if not more effective, than percutaneous cholecystostomy in managing the pain and re-intervention rates of acute cholecystitis.

“Sometimes the surgeons will opt to do this before surgery when the gallbladder is inflamed. We give the patient antibiotics and drain the gallbladder so that it isn’t hot, sticky, and inflamed during surgery,” Kumta says.

When Considering Treatment Options, Talk to Your Doctor

As a gastroenterologist, Kumta always refers people to a surgeon if they are experiencing pain in their right abdomen, so that they can learn the pros and cons of removing the gallbladder.

Still, Kumta says that obesity is correlated with gallstone formation, and that patients can make dietary changes, lose weight if they are obese, and opt for a low-fat diet.

If you pick the change your diet, “wait and see” approach, be mindful of the factors that predispose someone to gallstones: You can’t control your age, your gender (women are more prone to gallstones), or your genes.

If you have gallstones, knowing what’s available to remove or otherwise treat them can help you in making your treatment decisions. Discuss these treatment options with your doctor and find the one that’s right for you.

Additional reporting by Calley Nelson

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City Clinical Hospital No. 31 im. Academician G.M. Savelyeva – Pills or surgery?

The surgical treatment of gallstones has long been recognized as the most effective and safest. However, many still doubt it.

What worries our readers the most?

Doctor of Medical Sciences, Head of the Department of Hospital Surgery of the Russian State Medical University, surgeon of the City Clinical Hospital No. 31 of Moscow, professor Sergey Georgievich Shapovalyants

1) Why remove the gallbladder if only one small stone has formed in it?

– Small stones in this case do not mean a small problem. On the contrary, they often cause serious complications.

If large formations lead to bedsores and gallbladder ruptures, then small stones are insidious in their own way. They can easily move and penetrate the bile ducts.

Wandering through them, the stones reach the duodenum. There, sooner or later, they get stuck, blocking the outflow of bile. Because of this, mechanical jaundice occurs.

Moreover, an attack of acute pancreatitis may suddenly develop. In this case, an ambulance from a doctor is needed.

Therefore, small stones should not be ignored. Even if at least one is found, you need to act. To date, the only treatment for gallstone disease is surgery – removal of the gallbladder.

2) There is a method of dissolving stones with the help of medicines. Why not try it before going to the surgeon?

– Indeed, there are such preparations. But the difficulty is that they rarely completely dissolve the stones. As a rule, drugs only slightly reduce them. The stone doesn’t go anywhere, it just gets smaller. Whether this is good or bad is a big question. As we said above, small stones cause no less problems than large ones.

Moreover, drugs are only effective against cholesterol stones. If they have a lot of calcium, conservative methods are useless.

One more thing. The size of the stones should not exceed 2 cm. It does not make sense to dissolve larger formations. This will take too long. After all, the stone, on average, decreases by no more than 1 mm per month.

It is not worth spending months or even years on this procedure. After all, no one can give a 100% guarantee of a successful result. And the risk of starting a problem is quite high.

Use with extreme caution in people with other gastrointestinal disorders. It is impossible to dissolve stones with stagnation of bile, acute inflammatory diseases of the gallbladder and bile ducts, liver diseases, stomach and duodenal ulcers, and problems with the intestines.

In addition, this seemingly harmless method of dealing with gallstones has its own side effects. The most common is stool disorder. And given that conservative treatment is designed for a long period, then it is unlikely that it will be possible to “endure” unpleasant reactions.

The situation is not easy. On the one hand, the method of drug dissolution of stones is quite safe – no anesthesia, incisions, postoperative rehabilitation is needed. On the other hand, it has many limitations and is not very effective.

3) How effective is the method of crushing gallstones, because kidney stones are crushed?

– The analogy between kidney stones and gallstones is often used. But these are completely different diseases, each of which manifests itself and is treated in its own way. Bringing them to the same denominator is incorrect.

At one time, the method of crushing gallstones using extracorporeal lithotripsy was widely used. During the session, multiple shock waves were directed at the stone from the outside. As a result, it was broken up into fragments, which then independently exited through the bile ducts and intestines.

In fact, not everything went so smoothly. Large fragments could not pass through the duct, so they remained in the gallbladder. Most of the small ones left “their place of residence”. But some of them got stuck in the bile ducts, clogged them and disrupted the process of bile formation. Therefore, after such a procedure, sometimes it was necessary to urgently do an operation.

There is one more important nuance. Usually gallstones are even, smooth, adapted to the shape of the gallbladder. Outside the attack, as a rule, they are not felt in any way. But after crushing, fragments are formed, which can cause colic and other painful sensations.

Due to the impressive number of undesirable consequences, this method is practically not used today. And in some foreign clinics, it is generally prohibited.

4) Is it possible to remove only stones and leave the gallbladder?

– It is possible, but this method is now recognized as ineffective. There is an opinion that some people, especially young people, should not have their gallbladder removed. After all, it performs important functions in the body.

Proponents of this approach perform an operation during which a small incision is made in the gallbladder. Through it, gallstones are taken out. Then the bladder is sutured, and after two or three days, a satisfied patient returns home. Without stones, and with a preserved gallbladder.

But not everything is so simple. Approximately 2-3 months after such an operation, the disease begins to bother again. The percentage of her return of the disease at different intervals reaches almost 100%. The fact is that one of the prerequisites for the formation of stones in the gallbladder is its poor contractility. Bile stagnates in it, from which stones are then formed.

Another reason is the individual characteristics of the bile itself. With any diet, even the lightest, it concentrates and precipitates. In this case, the elimination of stones alone simply does not make sense. Finally, the problem can be solved only by the complete removal of the gallbladder.

5) What are the advantages of laparoscopic stone removal?

– For a long time, gallstones were removed by the usual abdominal method. But today, many large hospitals and clinics are switching to a simpler and safer technique – laparoscopy.

The whole operation is carried out through three or four punctures in the abdominal wall. A miniature optical system is inserted through them. With its help, the abdominal cavity is examined, and then the gallbladder is removed with special tools.

As a rule, this is where the patient’s troubles end. After a short period of adaptation, he will be able to forget about gallstone disease forever.

Moreover, the absence of a gallbladder will be almost imperceptible. Indeed, in fact, his “biological loss” occurred much earlier – even at the stage of stone formation. Even then, the gallbladder stopped working normally, and other organs took over its “duties”.

6) Quite often, after removal of the gallbladder, a person feels even worse than before the operation. Maybe she doesn’t need it at all?

– There is such a thing as postcholecystectomy syndrome. This is a deterioration in well-being after removal of the gallbladder. Most often this happens if the operation is performed at an advanced stage of the disease, when neighboring organs are involved in the process.

In this situation, only one thing can be said – do not take things to extremes. Do the operation as planned, and not when the “thunder strikes.” Then problems can be easily avoided.

There is another reason – insufficiently serious preliminary examination. Today, removal of the gallbladder is considered a technically simple procedure for doctors and easily tolerated by patients. Therefore, the range of preliminary tests is often limited to one ultrasound of the abdominal cavity. And this is extremely small.

To get a complete picture and find out the true cause of poor health, it is necessary to carefully examine not only the gallbladder, but also all nearby organs. It is necessary to carefully assess the condition of the bile ducts, pancreas, duodenum, right kidney, stomach.

Not all medical institutions are equipped for this. Therefore, it is better to contact large clinics and centers.

When stones are suspected, endoscopic bile duct ultrasonography is now used successfully. It is performed using a miniature ultrasound probe or endoscope, at the end of which is an ultrasound probe. If there are stones in the bile ducts, you first need to eliminate them, and only then take on the gallbladder.

Computed tomography can help examine the liver and pancreas. Many of the necessary details will tell a biochemical blood test. Of course, not everyone needs these studies. But if there are at least some doubts, they cannot be ignored.

It is a thorough examination before surgery that allows you to choose the right tactics for treatment, preparation and recovery period. After all, the goal of surgical manipulations is not just to remove the problem, but to make it the most comfortable way for the patient.

It is now possible to remove gallstones without surgery

Author State TV and Radio Company “TAMBOV” Reading 2 min. Views 3k. Posted by 30.08.2022

Diagnosis and treatment of diseases of the biliary tract in Tambov is now carried out using high-precision equipment. A new generation endoscopic device has appeared at the disposal of the doctors of the regional clinical hospital. It shows the internal state of the patient and at the same time dispenses with a single incision. With his help, the first procedures to remove stones from the gallbladder have already been carried out. Our film crew also watched the progress of such an operation.

Nina Lavrentyevna is one of those patients who postpone a visit to the doctor until later. For a long time she took pain pills, and when they stopped helping, she surrendered to the doctors. From Michurinsk, the woman was sent to the regional hospital, and here she was diagnosed with a gallbladder full of stones.

I, of course, brought myself to the last degree, there is nowhere further. In a word, I expect doctors to get rid of this misfortune,

– Nina Rychko.

Every year about 150 such surgeries are performed in the surgical department of the regional hospital. Gradually introduced minimally invasive manipulations. And the new device does work on the principle of conventional gastroscopy.

Contrast is injected into the ducts and an x-ray is taken. If there are stones, then this large duodenal papilla is cut with special tools and stones are removed with the help of baskets,

– Natalya Nikolaeva, head of the endoscopic department of the Tambov Regional Clinical Hospital named after I.I. V.D. Babenko.

These baskets, their size is selected individually, depending on the patient’s condition. The device allows for a complete diagnosis of the biliary system.

There are stones there, there are no stones there, what is the cause of jaundice, what is the reason for the violation of the outflow of bile – all this can be established with a very high probability during the study,

– Vladimir Pominov, Head of the Second Surgical Department of the Tambov Regional Clinical Hospital. V.D. Babenko.

– The duodeoscope has become a real lifesaver for older patients with gallstone disease. Until now, in giving them such a diagnosis, doctors were essentially trapped: the only treatment was surgery – it also represented rice for life. The endoscopic method is less traumatic. It allows you to remove stones of any size, while the risk of complications is minimized here.

The most formidable consequence is pancreatitis. The pancreas reacted with inflammation to surgery to remove stones. The new technique, combined with drug therapy, eliminates the negative scenario.