Nonsurgical Treatment of Gallstones

During the past 18 years, three approaches have been introduced as alternatives to surgical treatment of gallbladder stones,1 2 3 4 a condition known since antiquity. All have as their objective the dissolution of the stones, leaving the gallbladder intact and stone-free. Elimination of the stones should be accompanied by relief of symptoms and should prevent the development of more serious complications — e.g., cholecystitis, pancreatitis, cholangitis, or obstructive jaundice.In contrast to cholecystectomy, for which prior knowledge of the composition of the stones is unnecessary, dissolution therapy is effective only for cholesterol stones. Gallstones composed predominantly of pigment (bilirubin polymers) or calcium . . .