Treatment of choice for gallstones

A/medical measure with medications

Gallbladder stones can sometimes be dissolved by a chemical (ursodiol or chenodiol), which is available in pill form. This medicine thins the bile and allows stones to dissolve. Unfortunately, only small stones composed of cholesterol dissolve rapidly and completely and its use is therefore limited to patients with the right size and type of stones.

B/surgical intervention :laparoscopic cholecystectomy

Laparoscopic cholecystectomy has become common and is now used for more than 90 percent of all gallbladder removals in the U.S. However, it cannot be used in all cases. For instance, it may be difficult or dangerous to remove a severely inflamed gallbladder laparoscopically. It may also be more difficult to remove a stone from the bile duct laparoscopically, if one is found at surgery to have passed out of the gallbladder and into the duct. However, stones in the bile duct can frequently be removed with ERCP.

Gallbladder surgery may be complicated by injury to the bile duct, leading either to leakage of bile or scarring and blockage of the duct. Mild cases can frequently be treated without surgery, but severe injury generally requires bile duct surgery. Bile duct injury is the most common complication of laparoscopic cholecystectomy.