A gallstone formed within the gallbladder as a result of changes in bile acid (BA) metabolism and gallbladder function are critical factors in the pathogenesis of gallstones. Gallstones can cause blockage the flow of bile through the bile ducts that can lead to inflammatory causes of acute cholecystitis. Gallstones are most common among older adults, women, overweight people, etc.
Treatment
F.1. In conventional medicine perspective
1. Cholecystectomy
No treatment for people who have developed galldtones but with no
system, otherwise, surgery to remove the gallbladder may be necessary. Cholecystectomy is the surgical removal of the symptomatic gallbladder. In the sugery, It is the most common method for treating symptomatic gallstones, other surgeries include the laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy.
2. Others
a. Some researchers suggested for the treatment of gallstones
in patients with normal stonefree bile ducts, new modalities have been
developed besides the classical cholecystectomy and the oral litholysis.
The interventional procedures (local litholysis, extracorporeal
shockwave lithotripsy, combination of shockwave lithotripsy and local
litholysis, cholecystostomy and extra- or intracorporeal lithotripsy) do
not need a narcosis and can be applied even in high-risk patients.
Because the gallbladder itself is not removed, the recurrence rate after
all these interventions is rather high. The new operative procedures
(laparoscopic cholecystectomy, mini-laparotomy cholecystectomy) are
definitive solutions for stone disease, but must be performed mostly in
narcosis(13).
b. Today, cholecystectomy was still the most frequent method of treatment
for symptomatic cholecystolithiasis (n = 1369) with low morbidity
(4.3%) and lethality (0.28%). Probably less than 20% of all cases
fulfill the strict selection criteria for extracorporeal shock wave
lithotripsy (ESWL). All alternative methods of treatment
in which the gallbladder is preserved have an increased risk for gall
stone recurrence. Only after the long-term follow-up results of ESWL are
known, the recurrence rate can be assessed. In most cases, bile duct
stones (n = 417) were removed by endoscopy, if necessary in combination
with ESWL (n = 310, stone removal: 95%, lethality: 0.3%). However, in
low risk patients with concurrent cholecystolithiasis surgery was still
the method of choice (n = 107, stone removal: 96%, lethality: 0/107)(14).
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Sources
(13) http://www.ncbi.nlm.nih.gov/pubmed/2028140
(14) http://www.ncbi.nlm.nih.gov/pubmed/2721300
(15) http://www.ncbi.nlm.nih.gov/pubmed/21756271
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