Gallstones - Other Treatment

SYMPTOMS & TREATMENTS

Other treatment options for gallstones are not widely available. Less is known about their effectiveness and long-term impact compared to surgery.

Other Treatment Choices

Other treatments for gallstones in the gallbladder include:

  • Lithotripsy. This procedure usesultrasound waves to break up gallstones. It may be used alone or along withbile acids to break up stones. The procedure, which is now rarely performed,has been used for people who have long-term (chronic) inflammation of thegallbladder (cholecystitis) and who are not strong enough for surgery. But itis not appropriate in treating sudden (acute)cholecystitis.
  • Contact dissolution therapy. This treatment uses athin, flexible tube called a catheter to place a chemical in the gallbladder todissolve gallstones. This therapy is rarely used because of the risk ofcomplications. And unlike with surgery, gallstones may return.
  • Percutaneous cholecystostomy. This procedure may providetemporary relief for an inflamed gallbladder until an endoscopic retrogradecholangiopancreatogram (ERCP) or surgery can be performed. During percutaneouscholecystostomy, a doctor places a tube through the abdomen and into thegallbladder to drain its contents. This sometimes is done for people who arenot strong enough for surgery.

Other treatments for gallstones in the common bile duct include:

  • Endoscopic retrograde cholangiopancreatogram (ERCP) with endoscopic sphincterotomy.In an ERCP, a doctor gently moves a flexible, lighted viewing instrument (endoscope) down your throat and through your stomachto examine the tubes that drain your liver and gallbladder. If you have agallstone in the common bile duct, the gallstone can sometimes be removedthrough the endoscope. The doctor widens the opening between the common bileduct and the small intestine and takes the stone out using a small basket.Because surgery to remove the gallbladder prevents the return of gallstones, itis usually the best option. But you may have ERCP to remove stones in thecommon bile duct and then have surgery to remove your gallbladder.

What To Think About

Lithotripsy and contact dissolution therapy to treat gallstones are not used very often and are less effective than surgery to prevent symptoms caused by gallstones. Discuss with your doctor the risks, costs, and effectiveness of these seldom-used procedures.

When the gallbladder is not removed, such as in nonsurgical procedures, gallstones return within 5 years in 30% to 50% of people.3

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