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Gallstones (cont.)

Medical Treatment

There are medical treatments for gallstones, but none is effective as surgery.

Extracorporeal shockwave lithotripsy (ESWL): A device that generates shock waves is used to break gallstones up into tiny pieces.

These tiny pieces can pass through the biliary system without causing blockages.
This is usually done in conjunction with ERCP to remove some stones.
Many people who undergo this treatment suffer attacks of intense pain in the right upper part of the abdomen after treatment.
The effectiveness of ESWL in treating gallstones has not been fully established.

Dissolving stones: Drugs made from bile acids are used to dissolve the gallstones.

It may take months or even years for the gallstones to all dissolve.
The stones often come back after this treatment.
These drugs work best for cholesterol stones.
They cause mild diarrhea in many people.
This treatment is usually offered only to people who are not able to have surgery.

If an individual goes to an emergency department, an IV line may be started, and pain medication and antibiotics may be given through the IV.

If the patient's health permits it, the health care practitioner will probably recommend surgery to remove the gallbladder and the stones. Surgical removal helps prevent future episodes of abdominal pain and more dangerous complications such as inflammation of the pancreas and infection of the gallbladder and liver.

If there is no infection or inflammation of the pancreas, the operation to remove the gallbladder can be performed immediately or within the next several days.
If there is inflammation of the pancreas or infection of the gallbladder, the pateint will most likely be admitted to the hospital to receive IV fluid and possibly IV antibiotics for several days prior to the operation.