Gallstone : Treatment

The Initial Treatment would be for Pain and Analgesics (painkillers) would be required.

Subsequently, symptomatic gallstones are best treated surgically, a procedure called Cholecystectomy or removal of gallbladder.

(1) Open Cholecystectomy: In the past it was performed by making a large abdominal incision about 6 inches long in the gallbladder. The recovery period was also very long, almost taking about six weeks to get back to normal activities.

(2) Laparoscopic Cholecystectomy: Today Laparoscopic Cholecystectomy is the surgery of choice preferred by most patients. Unlike the traditional method it requires 3 to 4 one inch size keyhole incisions in the abdomen, through which the surgeon inserts a miniature video camera as well as surgical instruments .The camera is used to send a magnified image from inside the body which is viewed on a video monitor, to give the surgeon a closer view of the organs. Continuously monitoring the procedure on the monitor the surgeon uses the Laparoscopic instruments to carefully separate the gallbladder and finally remove it through one of the abdominal incisions. Another reason why it is preferred by most patients is because they could get back to their normal activities in a day or two .

Alternative treatments :

Though there are various alternative methods to treat gallstones, it does not involve the removal of the gallbladder, hence patients are faced with a significant risk of recurrence.

(1) Lithotripsy - Extracorporeal Shock wave lithotripsy using shock waves is sometimes done to treat common bile duct stones. It is a non-invasive and safe procedure.

(2) Oral Bile Acid Dissolution Therapy - This procedure involves frequent visits to the hospital and may take months or years before the stones could actually dissolve. In order to dissolve the stones ,drugs made from bile acid are used , however it works best for the treatment of small gallstones .

(3) Contact Dissolution Therapy - This procedure is still in its experimental stages as it involves the use of a drug called – methyl tertbutyl which is a flammable anaesthetic that can be toxic to the body. It involves injecting the drug directly into the gallbladder to dissolve stones. It is known to dissolve stones within 2-3 days.

(4) Endoscopic Sphincterotomy - This is the procedure of choice if gallstones cause jaundice. With the help of a fibre optic endoscope the opening of the common bile duct into the intestine can be reached. A sphincter called the sphincter of oddi guards the opening. A sphincterotomy or opening in the sphincter of oddi is made to extract stones.

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