The detection of gallstones does not always imply the operation. In some cases, it is sufficient to conduct competent drug therapy. The type of treatment chosen by the gastroenterologist and surgeon, based on the type of stones found in the patient and where they are localized.
Drug treatment of gallstones
If a person has cholesterol stones in the gallbladder, treatment can only be medicated. It is performed with the help of drugs ursodeoxycholic or chenodeoxycholic acid. Such medicines include tablets:
- Ursofalk ;
- Henosan;
- Ursosan;
- Genohol;
- Henofalk.
With their help, you can restore the normal ratio of bile acids and cholesterol. In this case, excess cholesterol is converted into a soluble form, which slows down, and sometimes completely stops the process of formation of stones. During the treatment with such drugs, you should exclude the use of various drugs that promote stone formation (for example, estrogens that make up various contraceptives).
Drug treatment of cholesteric stones in the gallbladder can be carried out only if the stones have not filled more than half of the organ, and the bile ducts have good permeability. The course of such therapy lasts up to 24 months, and its effectiveness is monitored at least 2 times a year by ultrasound.
Treating stones in the gallbladder with ultrasound or laser
If the diameter of the stones in the gall bladder does not exceed 3 cm, the treatment can be performed by laser or ultrasound. Call such therapy remote crushing - cholesterol, calcareous, pigmentary or mixed concretions are crushed into very small pieces (approximate size 1-2 mm). They are excreted from the body together with feces. This procedure is indicated only for patients who have sufficient contractility of the gallbladder. You can carry it if the number of pebbles does not exceed 3 pieces.
Treating stones in the gallbladder with ultrasound or a laser is an absolutely painless procedure. It is well tolerated by patients of different ages and can even be performed on an outpatient basis. As a rule, its duration is 30-60 minutes.
Removal of stones
If the stones are very large or the medicinal treatment of gallstones is ineffective, an operation is performed - open cholecystectomy or laparoscopic cholecystectomy. During open cholecystectomy, a cut of the abdominal cavity is made, the surgeon conducts an examination, removes the gallbladder, drains (if necessary) and sutures the wound. If drains (plastic tubes) were installed for blood outflow, wound exudate and biological fluids, then after a few days, they must be removed. This is also done by the surgeon.
Laparoscopic cholecystectomy is an operation to remove the gallbladder , which is performed with the help of endoscopic equipment and laparoscopes (a special tube with a lens system, a video camera and an optical cable that is equipped with a xenon lamp or other "cold" light source). This method has many advantages over conventional peration. It is less traumatic, as it is not done
Treatment of large or many small stones in the gallbladder by the method of laparoscopic cholecystectomy is contraindicated only when:
- pregnancy (3rd trimester);
- severe cardiopulmonary diseases;
- unclear anatomical situation.