Treatment of Gallstones

If you have gallstones but no symptoms, you do not need treatment. But if you're having frequent episodes of biliary colic, your physician will likely recommend that you have your gallbladder removed, an operation called a cholecystectomy, to prevent recurrences. Nearly all cholecystectomies are performed by laparoscopy, which decreases the amount of pain following the surgery and allows for a faster recovery than traditional open surgery.

During laparoscopic cholecystectomy, the surgeon may explore the common bile duct as well.

Pressure within the biliary tract, caused by stones that obstruct the bile ducts, can also be relieved by using ERCP to place a small tube (stent) into the common bile duct to keep it open. Stones in the common bile ducts can also be removed during ERCP.

ERCP uses a special device called a sphincterotome to cut the bile duct sphincter and then extract the stones from the bile duct with a special basket or balloon. Since stones are often still present in the gallbladder, a cholecystectomy should also be performed to prevent further obstruction.

Acute cholecystitis usually requires a hospital stay. Fluids and nutrients are given intravenously to let the digestive tract rest, and antibiotics are administered to eliminate the bacterial infection. Once acute cholecystitis develops, the gallbladder should be removed.

If you are unable to undergo surgery, the gallbladder can be drained by passing a tube into the gallbladder through a small incision in the abdomen. Ultrasound or CT is used to guide placement of the draining tube.

Publication Review By: H. Franklin Herlong, M.D.

Published: 24 Mar 2011

Last Modified: 23 Jul 2015