Gallstones

For stones that are caught in the common bile duct, an additional treatment might be required. Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure done by a gastroenterology specialist or surgeon to view the opening of the bile duct where it empties into the intestine. Using miniature instruments attached to a camera at the end of flexible tube that is inserted into the intestine through the mouth, the gastroenterologist can tug a stone out of the bile duct, or can widen the lower part of the duct so that the stones can pass out into the intestine on their own.

For people who cannot tolerate surgery, an oral medication known as ursodeoxycholic acid (Actigall) may be used to help dissolve stones. This treatment usually requires at least six months before results are seen and is only effective in about half of patients. Once the medication is stopped, gallstones are likely to return in most patients. Two other ways to break up gallstones are to use shockwaves (lithotripsy) or to dissolve the stones with solvents injected directly into the gallbladder with a needle. However, surgery is the preferred treatment because stones are likely to form again if the gallbladder is not removed.