What are treatment options for biliary colic?

Updated: Jan 18, 2017
  • Author: Peter A D Steel, MBBS, MA; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Answer

For simple gallbladder colic, other therapies are rarely performed, because they require long-term therapy (oral dissolution), cause complications (shock-wave therapy), and ultimately do not prevent the recurrence of gallstones.

Oral dissolution therapy consists of bile acid therapy with ursodeoxycholic acid sometimes in combination with chenodeoxycholic acid. With this treatment, cholesterol saturation of bile is decreased, and dissolution of small gallstones (<5 mm) is possible with 6-12 months of therapy; however, over 50% recur. Oral dissolution has several disadvantages, including the time frame of up to 2 years. Fewer than 10% of patients with symptomatic gallstones are candidates for this therapy. The doses are not listed, because this treatment option is chosen rarely.

Extracorporeal shock-wave lithotripsy is another little-used therapy due to the recurrence of stones. This treatment is not popular, because only small (<2 cm) stones can be fragmented, and also a recurrence of gallstones occurs in up 30% of patients within 5 years.

Percutaneous contact dissolution therapy by injection of methyl tert-butyl ether (MTBE) into the gallbladder to dissolve stones is rarely used.

There is evidence to support early laparoscopic cholecystectomy (42</ref>


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