Gallstones blocking the bile ducts or severe inflammation of the gallbladder caused by gallstones may require urgent care. Treatment for serious attacks includes hospitalization, administration of intravenous fluids and electrolytes, and antibiotics. If the diagnosis is inflammation of the bladder and the risk of surgery is small, the gallbladder may be removed within the next day or so. Gallstones blocking the bile duct may be removed with ERCP with or without subsequent removal of the gallbladder to reduce the risk of recurrence.
Maintaining a healthy body weight, avoiding foods high in fat or sugar, having a diet rich in fruits, vegetables, and fiber, exercising regularly, and avoiding crash diets will help reduce the risk of developing gallstones.
Your doctor is the best source of information on the drug treatment choices available to you.
Most gallstones do not require treatment. Many gallstones are detected when a person is being examined for some other purpose. In most of these cases, the physician will probably recommend taking a “wait-and-see” approach as long as the gallstones are not causing any symptoms.
Lithotripsy, or sonic shock wave therapy, may be used to break up gallstones. This process uses high-frequency sound waves to break gallstones into smaller pieces, followed by drug therapy to dissolve the remaining fragments. Because the treatment is limited primarily to small gallstones, and because it does not prevent their recurrence, lithotripsy is not commonly used.
Injection of methyl tert-butyl ether (MTBE) may be used to dissolve cholesterol gallstones. In this process, MTBE is injected directly into the gallbladder through a catheter to dissolve gallstones. It is not widely available, and is used primarily when surgery is not an option. As with lithotripsy, MTBE does not prevent gallstones from coming back.
The most common treatment for gallstones that cause recurrent attacks is surgical removal of the gallbladder. In the past, gallbladders were removed primarily through a relatively large open incision in the abdomen wall. In 1990, a surgical procedure called laparoscopy was introduced, and now the vast majority of gallbladders are removed this way. In a laparoscopy, the gallbladder is removed through small flexible tubes inserted through small incisions in the abdomen. Laparoscopic removal generally has fewer complications and shorter healing times. Overnight hospitalization may not be required, and complete recovery may occur within a week. Laparoscopic removal may not be an option when extensive scar tissue from previous abdominal operations is present.
If difficulties are encountered during the laparoscopic procedure, an open operation may be necessary.
Gallstones blocking the bile ducts may be removed using ERCP with or without surgical removal of the gallbladder. In people over the age of 60, ERCP without gallbladder removal is usually the treatment of choice, because recurrence of gallstones in the bile ducts occurs infrequently. Younger patients with gallstones in the bile duct have a higher risk of recurrence, so removing the gallbladder is usually recommended.
Although you may have gallstones, your abdominal symptoms may not always be related to them. In case of any unusual symptoms or alarm symptoms such as fever, yellowing of the skin and eyes (jaundice), clay-colored stools, or coffee-colored urine, contact your doctor or check with the medical emergency room.
Removing the gallbladder usually cures gallstone disease. However, in a small percentage of cases, gallstones may recur in the bile ducts even after the gallbladder has been removed. When gallstones are removed from the bile duct without removing the gallbladder, gallstones may also recur.
Removing the gallbladder may change the consistency of your bowel movements. Although removing the gallbladder does not affect a person's ability to digest food, it may increase your number of bowel movements and decrease their firmness. In most cases, these symptoms eventually improve over time.
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