The gallbladder is located on the upper right side of the body just under the ribcage and the liver. The National Digestive Diseases Information Clearinghouse states that sex, diet, age, weight and family history are factors in gallstone formation. Stones can lodge in any one of the common bile ducts, hepatic ducts and cystic duct, blocking the natural flow of bile from the liver to the small intestines. Treatments for gallbladder stones can help eliminate blockages.
Expectant Management
Expectant management is a term that has been adopted to describe a wait-and-see approach to gallstones that are asymptomatic. The American College of Physicians maintains that the risks of gallbladder surgery outweigh the benefits for patients who experience no symptoms. Exceptions do exist when the likelihood of gallbladder cancer is evident, with stones that are larger than 3cm, and if a high risk group, such as the Pima Native Americans, are affected. If the stones are smaller than 5mm, some doctors will recommend removal due to the risk of acute pancreatitis.
Cholecystectomy
Surgery to remove the gallbladder, called a cholecystectomy, is one of the most common surgeries in the United States, according to the National Digestive Diseases Information Clearinghouse. A laparoscopy and a miniature video camera are inserted through small incisions in the abdomen and the gallbladder is surgically removed from the liver and bile ducts. Because muscles are not cut, day surgery is usually an option. As of 2010, laparoscopic cholecystectomy has by far replaced open cholecystectomy, a procedure requiring a wide abdominal incision and a longer recuperation time. Laparoscopic surgery is less invasive, there is less postoperative pain and fewer complications.
Drug Therapy
Drug therapy is a non-surgical mode of treatment for cholesterol gallstones. There are two options available. Oral dissolution therapy involves medications made from bile acid. Taken orally, it may take months or years to dissolve the stones. Contact dissolution therapy is still an experimental procedure in which methyl tert-butyl ether, a drug that can dissolve stones in two to three days, is injected directly into the gallbladder. The procedure is still in the testing stages and has been found to cause irritation.
ERCP and ES
Endoscopic retrograde cholangiopancreatography, or ERCP, and endoscopic sphincterotomy, or ES, involve the passing of an endoscope through the mouth, stomach and into the small intestine to where the common bile duct empties. Dye is injected into the duct allowing X-rays to reveal the gallstones. ES involves making a small incision in the sphincter of the duct allowing the stones to be removed. It is considered a difficult procedure and the University of Maryland Medical Center recommends that it should only be performed by an experienced surgeon.
