The symptomatic gallstones will be treated. Most often this treatment is surgical and more rarely treated by nonsurgical techniques. Since the laparoscopic colecistectomy was introduced, the trust of patient into the intervention has increased. It involves a safe intervention, a short hospitalization and minimal postoperatory inconvenient (when the surgeons are well trained in this technique). The uncomplicated cholelithiasis cases are usually treated by this technique, but also the acute cholecistitis or vesicular hydrops. In the scleroatrophic lithiasic cholecistitis or when there is a suspicion of common bile duct lithiasis, the classic technique of open colecistectomy is preffered. In case of common bile ductolithiasis suspicion the exploration of common bile duct is mandatory.
The nonsurgical techniques of treatment of gallstones are the medicamentous litholisis and the extracorporeal lithotripsy.
Medical therapy (gallstone dissolution) is effective in the cholesterol calculi, preferably small, those fill in less than a half of the vesicular volume and when the gallbladder has a permeable infundibulo - cystic zone. The therapy consists in the administration of ursodeoxycholic acid (10 mg / kg body / day) - Ursofalk or its combining with chenodeoxycholic acid (10 - 15mg / kg body / day) - Litofalk for 3 - 12 months, up to the complete solubilisation of calculi. The overseeing of the results is made by ultrasonography.
Extracorporeal lithotripsy consists of fragmenting the cholesterol calculi by extracorporeal shock waves; it addresses to the unique or less numerous calculi, preferable under 15mm. The fragments resulted from lithotripsy will then be solved by administrating billiary acids up to the complete disappearance of all calculi fragments from the bladder. Both nonsurgical techniques are relatively-expensive.
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