There are several treatment methods used for the removal of gallstones, both surgical and non-surgical. The specific treatment given to a patient depends on a number of factors, including composition of gallstones, specific symptoms and personal medical history. If gallstones don't cause signs and symptoms, treatment is usually not necessary, according to the Mayo Clinic. If the presence of gallstones is confirmed, it is important for the patient and health care provider to discuss and agree upon the proper treatment method.
Laparoscopic Cholecystectomy
Laparoscopic cholecystectomy is a minimally invasive procedure and the most common treatment method for gallstones. During this procedure, the patient is placed under general anesthesia and small incisions are made in the abdomen. There are usually four incisions that measure no greater than 1/2 inch each. After the incisions are made, plastic tubes called ports are placed into them. A laparoscope, which is a thin, lighted tube with a camera at the tip, is then threaded through the incisions and the image is shown on a television in the operating room. The surgeon uses this camera along with surgical instruments to carefully cut the gallbladder out of place in the body and gently remove it. Patients receiving this treatment option experience a faster recovery time and minimal post-operative pain.
Open Cholecystectomy
An open cholecystectomy is a largely invasive surgical procedure used to remove the gallbladder. The entire surgery, during which the patient is placed under general anesthesia, takes approximately one hour. A 5- to 7-inch incision is cut under the right rib cage, exposing the internal organ. The bile ducts and blood vessels that lead to the gallbladder are cut, after which the gall bladder is gently removed. During the procedure, a dye is injected into the common bile duct. An X-ray, called a cholangiogram, is done to find gallstones located outside the gallbladder. If gallstones are found, the surgeon will remove them as well. An open cholecystectomy is the most extreme treatment method and is used only in complicated situations, such as significant inflammation of the gallbladder or if the patient had prior abdominal surgery.
Lithotripsy
A lithotripsy is a non-surgical treatment method. During a lithotripsy, the patient lies on an exam table on top of a water-filled cushion after being given a mild sedative or pain medicine and antibiotics to prevent infection. High-energy shock waves are passed through the body until they hit the gallstones. The waves break the gallstones into small pieces, which pass through the urine. The procedure is monitored by an ultrasound. The whole process takes 45 to 60 minutes and is seldom used. For someone to be eligible for a lithotripsy, his or her gallbladder must be functionally intact and the gallstones cannot be calcified and not have a diameter exceeding 2 cm.
Oral Dissolution Therapy
Oral dissolution therapy is another non-surgical treatment option. Capsules containing ursodeoxycholic acid, which is a water-soluble bile acid, are taken by the patient to dissolve the cholesterol from which the stones are made. The bile acid can also reverse the process of stone formation. This procedure is suitable for patients whose gallstones are primarily made up of cholesterol and do not exceed 5 to 10mm in diameter. The complete process takes nine to 12 months, so those who experience pain because of gallstones are not eligible for this treatment. The drugs may also cause mild diarrhea and temporarily raise levels of blood cholesterol, according to the National Institutes of Health.
