Management
If the patient symptoms are uncomplicated pain control, morphine sulfate, etc. may be the most appropriate avenue. Laparoscopic cholecystectomy is then performed in order to remove the stones.
Other therapeutic options include:
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Percutaneous Choleycystolithotomy (draining gallbladder via a tube). This is a new procedure is usually not utilized commonly. |
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ECSWL: (extracorporeal shock wave lithotripsy) this treatment involves high frequency ultrasound waves to break the stones into smaller fragments. This is inexpensive method that is not utilize commonly for gallstones. Rather, it is used more commonly in patients who have kidney stones. Patients with gallstones who have a solitary small stone (3 mm in diameter or less) are the best candidates. This therapy is usually combined with bile acid therapy. Patients have variable rates on clearance. These range between 50 to 90 percent. |
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Contact dissolution: MBTE is a compound that allows for dissolution of gallstones. The gallstone must be washed with MBTE continuously for this to be effective. This is usually done through a tube placed in the gallbladder by a radiologist. At this time, 36 to 67 percent of patients can have partial dissolution of gallbladder stones. |
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Oral bile acid therapy: chenodeoxycholic acid therapy will lower the cholesterol levels in bile acids. This decreases the saturation of cholesterol. Patients who then treated in this manner have 40 to 60 percent dissolution rates at the end of two years. |
Contraindications: any of the above constitute contraindications to nonsurgical treatment of gallstones:
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Pigment stones. |
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Stones with calcifications. |
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Stones greater than 1.5 to 2.0 cm in diameter. |
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Multiple stones. |
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Abnormal either skin or oral or oral cholecystogram. |
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Obesity |
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Pregnancy. |
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Liver disease. |
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Lack of response after nine months worth of treatment. |
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Poor patient compliance. |
Side effects: with any of the above Seeker toward diarrhea may occur. Passage of small stones through the cystic duct and subsequently in the common bile duct do occur. Priceless in percent patients had abnormal liver function test. Elevated LDL levels also occur.
Stones may recur within 6 to 48 months depending upon the treatment selected by your physician. In many cases therapy must be continued indefinitely.
Globetrotter's Pocket Doc - the only English international medical communication book for travelers to foreign countries
Other Liver Pages:
- Acute Acalculus Cholecystitis |
Acute Calculus Cholecystitis |
Albumin |
Alcoholic Cirrhosis |
Alcoholic Liver Disease |
Alpha 1 Antitrysin Deficiency |
Autoimmune Hepatitis |
Bilirubin |
Common Bile Duct Stones |
Esophageal Varices |
Gallstones |
Hemochromatosis |
Hepatitis G Virus |
Hepatitis - General |
Hepatitis A |
Hepatitis B |
Hepatitis C |
Hepatitis D |
Hepatitis E |
Iron Overload Diseases |
Primary Biliary Cholangitis |
Primary Sclerosing Cholangitis |
Wilson's Disease
Related Links
- Definitions |
Liver Function Tests
Patient Education:
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