The treatment of gallstones (biliary colic ) is varied.
Gallstones that do not cause any symptoms also need no therapy. An exception are gallstones, which are particularly large. If these exceed a critical size of 3 cm in diameter, they are expected to trigger symptoms in the foreseeable future and lead to gallstones.
Then an elective, ie planned and not emergency, operation is indicated. A chronic gallstone disease can trigger a so-called porcelain gallbladder by the resulting recurring inflammation. The name is correct because the gallbladder looks like porcelain due to its calcification in the ultrasound image. Since there is always the danger that a malignant tumor ( carcinoma ) will develop from this porcelain gallbladder, these patients are also advised to undergo surgery in the treatment of gallstones.
Gallstones that are symptomatic should be treated surgically. In almost all cases you remove the entire gallbladder with the stones lying in it. For this purpose, the so-called laparoscopic cholecystectomy is performed.
The surgeon makes four small skin incisions into which surgical instruments are inserted. Under the camera view, the surgeon releases the gallbladder and removes it through a previously introduced tube. If the patient belongs to a risk group ( adhesions due to previous operations or anatomical features ), open removal of the gallbladder is considered.
Instead of small skin incisions, a longer incision is made in the right upper abdomen during this therapy. The surgeon operates under view. Today, the laparoscopic surgical technique has largely superseded the conventional open. It is still used only in exceptional cases.
A colic (gallstone disease) can also be treated symptomatically.
Patients are usually given painkillers ( analgesics ) and anticonvulsants (eg butylscopolamine ) with a 24-hour food intake. Surgery is advisable even after successful treatment of colic (gallstone disease). If gallbladder inflammation is suspected, treatment with antibiotics should be initiated. A treatment option that is rarely used today is the dissolution of the gallstone.
The therapy must be carried out for two years. The success rate is only 70%. The shattering of gallstones by shock waves from the outside is also used in rare cases. However, both mentioned, alternative therapy require a certain stone composition. If there is a gallstone in the bile duct, the bile duct must first be slightly cut through the above-mentioned ERCP and finally the solid gallstone must be recovered with a small basket.
Homeopathic approaches to therapy can also be found at: Homeopathy in gallstones
After removal of the gallbladder, most patients have a good chance of never getting gallstones (biliary colic) again. In some cases, however, it can happen that the stones form in the bile duct and cause pain there. Patients who suffer from hereditary gallstones or fail to turn off the above-mentioned risk factors are usually affected. In general, the prognosis is very good after surgery. Non-operative gallstone treatments have a worse prognosis. As mentioned above, these often only have a 70% success rate.
Of course, many risk factors, such as age or gender, can not be influenced. But dietary habits may change (no low-cholesterol, low-fiber diet) and body weight may be reduced. Drinking a glass of milk at night should cause the gall bladder to drain, reducing the risk of gallstones.