Gallstones - Treatment

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How can Gallstones be Treated?

Symptomatic gallstones are best treated surgically with a procedure called cholecystectomy i.e. surgical removal of gallbladder. A diet free of fatty foods is recommended for the first week following surgery.

► Open cholecystectomy - It is performed by making a large abdominal incision about 6 inches long in the gallbladder. The recovery period is very long, almost taking about six weeks to get back to normal activities.

► Laparoscopic cholecystectomy - Laparoscopic cholecystectomy is the surgery of choice these days. Unlike the traditional method it requires 3-4 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 viewing 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 can get back to their normal activities in a day or two.

Alternative Treatments options -

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

► 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.

► Medication - Medicines like chenodeoxycholic acids or ursodeoxycholic acid are used to dissolve the cholesterol gallstones. It may take months or years before the stones could actually dissolve. This therapy works best for the treatment of small gallstones.

► Contact Dissolution Therapy - This procedure is still in its experimental stages as it involves a drug called- methyl tertbutyl. It involves injecting the drug directly into the gallbladder to dissolve stones. It is known to dissolve stones within 2-3 days. It is a flammable anesthetic and can be toxic to the body.

► Endoscopic Sphincterotomy - This is the procedure of choice if gallstones cause jaundice. With the help of a fiber optic endoscope the opening of the common bile duct into the intestine can be reached. Sphincter of oddi guards the openingA sphincterotomy or opening in the sphincter of oddi is made to extract stones.

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