What Are the Alternatives to Gallbladder Surgery?
In addition to surgery, nonsurgical approaches have been pursued but are used only in special situations and only for gallstones that are predominantly cholesterol.
Oral dissolution therapy with ursodiol (Actigall) and chenodiol (Chenix) works best for small, cholesterol gallstones. These medicines are made from the acid naturally found in bile. They most often are used in individuals who cannot tolerate surgery. Treatment may be required for months to years before gallstones are dissolved.
Mild diarrhea is a side effect of both drugs; chenodiol may also temporarily elevate the liver enzyme transaminase and mildly elevate blood cholesterol levels.
Two therapies, contact dissolution with methyltert butyl ether instillation through a catheter placed into the gallbladder and extracorporeal shock-wave lithotripsy (ESWL), are still experimental.
Each of these alternatives to gallbladder surgery leaves the gallbladder intact; so stone recurrence, which happens in about one-half the cases, is a major drawback.
Oral dissolution therapy with ursodiol (Actigall) and chenodiol (Chenix) works best for small, cholesterol gallstones. These medicines are made from the acid naturally found in bile. They most often are used in individuals who cannot tolerate surgery. Treatment may be required for months to years before gallstones are dissolved.
Mild diarrhea is a side effect of both drugs; chenodiol may also temporarily elevate the liver enzyme transaminase and mildly elevate blood cholesterol levels.
Two therapies, contact dissolution with methyltert butyl ether instillation through a catheter placed into the gallbladder and extracorporeal shock-wave lithotripsy (ESWL), are still experimental.
Each of these alternatives to gallbladder surgery leaves the gallbladder intact; so stone recurrence, which happens in about one-half the cases, is a major drawback.
posted by Jerry at 9:40 PM
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