Treatment
Patients with diagnosed but asymptomatic gallstones do not require any treatment but are monitored in case they develop any symptoms.
The treatment for symptomatic gallstone disease can be non-surgical and surgical.
The treatment for symptomatic gallstone disease can be non-surgical and surgical.
Non Surgical Treatment
1. Advise low cholesterol and high fibre diet.
2. Medications: Pain killers such as NSAIDs and proton pump inhibitors PPIs are given to relieve pain. Antibiotics for complications of gallstones are also given.
3. Gallstone Dissolution Therapies: Cholesterol gallstones can be dissolved either by taking oral medications or by organic solvents
a. Oral dissolution agents: Drugs such as Chenodeoxycholic acid and Ursodeoxycholic acid are given orally to dissolve cholesterol stones. They work by inhibiting the release of cholesterol into bile and increase the bile salt pool and also gradually dissolve the cholesterol stones in the gallbladder. The disadvantage of these drugs is that they can take up to 2 years to dissolve the stones.
b. Organic dissolution agent: Methyl tert-butyl ether MTBE is a very powerful organic solvent. It is introduced into the biliary system through a catheter which is passed percutaneously under radiological guidance. After several hours the stones are dissolved and the liquid is aspirated through the catheter and then the catheter is removed.
4. Lithotripsy: Extra-corporeal shock waves are given guided by ultrasound. It only works if the stones are small, hard and few (1-3) in number and the gallbladder is functioning.
2. Medications: Pain killers such as NSAIDs and proton pump inhibitors PPIs are given to relieve pain. Antibiotics for complications of gallstones are also given.
3. Gallstone Dissolution Therapies: Cholesterol gallstones can be dissolved either by taking oral medications or by organic solvents
a. Oral dissolution agents: Drugs such as Chenodeoxycholic acid and Ursodeoxycholic acid are given orally to dissolve cholesterol stones. They work by inhibiting the release of cholesterol into bile and increase the bile salt pool and also gradually dissolve the cholesterol stones in the gallbladder. The disadvantage of these drugs is that they can take up to 2 years to dissolve the stones.
b. Organic dissolution agent: Methyl tert-butyl ether MTBE is a very powerful organic solvent. It is introduced into the biliary system through a catheter which is passed percutaneously under radiological guidance. After several hours the stones are dissolved and the liquid is aspirated through the catheter and then the catheter is removed.
4. Lithotripsy: Extra-corporeal shock waves are given guided by ultrasound. It only works if the stones are small, hard and few (1-3) in number and the gallbladder is functioning.