Updates in the treatment of gallstones

Abstract

For the treatment of symptomatic gallbladder stones, laparoscopic cholecystectomy is the procedure of choice. However, open cholecystectomy is advisable in some situations, and a new technique – natural-orifice transluminal endoscopic surgery – has been described recently. In addition, nonsurgical approaches have also been used in patients with gallbladder stones. For the treatment of common bile duct stones, endoscopic approaches comprise the most important and commonly used modality but, under certain conditions, surgical removal should be considered if the stones cannot be managed nonsurgically. Patients with concomitant gallbladder and common bile duct stones may have various options, depending on the patient’s condition and the availability of local expertise. Intrahepatic stones usually have a lower rate of successful treatment compared with gallbladder or extrahepatic bile duct stones. Localized intrahepatic bile duct stones may be cured by surgical resection, or they may be safely and effectively managed using peroral or percutaneous cholangioscopy. Overall, a multidisciplinary approach is important for the optimal management of difficult gallstone diseases.

Keywords::

• extrahepatic bile duct
• gallbladder
• gallstone
• intrahepatic bile duct
• treatment

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.