Treatment for a Large Gallstone

Women who pass a gallstone will often compare the pain to childbirth. Gallstones vary in size—some are as tiny as a grain of sand, while others are golf ball size. The complications which arise from gallstone formation eventually make gallbladder removal necessary.

Definition

• A gallstone is a hard, pebble-like deposit made of cholesterol. Cholesterol normally dissolves in bile, but when the liver secretes too much cholesterol, the bile becomes oversaturated with cholesterol. This excess of cholesterol turns into solids called cholesterol crystals. The cholesterol crystals eventually form a gallstone. The amount of cholesterol in your blood, however, does not determine whether or not you will develop gallstones.

  There are also gallstones made from calcium deposits and bilirubin, a pigment found in bile. These are called pigment stones and are usually brown or gray.

Risk Factors

• Being a woman is a risk factor for developing gallstones, since gallstones afflict more women than men. Obesity, western diet and a family history of gallstones are additional factors which contribute to gallstone formation.

Gallstone Symptoms

• According to Merck Manual, 80 percent of people with gallstones do not experience any symptoms for many years. The best way to find out if you have gallstones is to have an ultrasound.

  Gallstone symptoms include pain in the upper or middle abdomen, fever, yellowing of the skin and whites of eyes. Pain occurs when a gallstone blocks the cystic duct and the gallbladder swells. The swelling of the gallbladder leads to the erosion of the gallbladder lining. A perforated gallbladder then leaks its contents into the abdominal cavity. When symptoms and complications occur, surgery is necessary.

Gallbladder removal

• When gallstones cause severe symptoms and complications, gallbladder removal is necessary. Laparoscopic cholecystectomy refers to the removal of the gallbladder using a laparoscope. The surgeon makes three incisions and places the laparoscope. The instrument is a thin tube with a light which allows the surgeon to see inside. First, the bile ducts and blood vessels leading to gallbladder are cut, and then the gallbladder is removed.

  After the gallbladder is removed, the surgeon will squirt a dye into the bile duct in order to perform a special x-ray. This allows the surgeon to find out whether or not you have any remaining gallstones outside the gallbladder. If found, the gallstones are removed.

  The advantage of this procedure is that it is not as invasive as traditional gallbladder removal.

Non-surgical Treatment

• In the case of patients who cannot have the surgical procedure, there is lithotripsy. It is an electrohydraulic shock wave (ESWL) which breaks up the gallstone. It is used infrequently because the gallstones recur.

  Medication is also available for certain patients. Doctors will prescribe Chenodeoxycholic acids (CDCA) or urodeoxycholic acid (UDCA) which dissolves cholesterol stones. Again, the drawback here is that the gallstones are likely to return. According to Merck, large gallstones require up 2 years of drug therapy to dissolve, and some never dissolve. This treatment is reserved for those patients who cannot undergo surgery due to another serious health condition.