Not all patients with gallstones require treatment. Asymptomatic gallstones may be managed expectantly.

It is estimated that in Western countries around 1/4 patients will become symptomatic over a period of 5-10 years. It is rare for the first presentation of gallstones to be life threatening.  Almost all patients present with at least one episode of biliary colic. Once gallstones become symptomatic, surgical intervention is usually indicated

Gallstone Dissolution

There are drugs (Ursodeoxycholic acid) that may be able to dissolve cholesterol gallstones. They are not funded in New Zealand for this indication, are associated with side effects (diarrhoea), may need to be taken for a number of years and the stones usually recur once you stop taking the medication.

Removal of Gallbladder 

Surgery involving the removal of the gallbladder is called cholecystectomy (koh-luh-sis-TEK-tuh-me). It can be performed either laparoscopically (key hole surgery) or open depending upon the indication.  This remains the primary treatment modality for patients with gallstones.  Laparoscopic cholecystectomy is the treatment of choice using keyhole type incisions under a general anaesthetic.  Cholecystectomy effectively prevents future further complications of gallstones, however 5-10% of patients will be found to have stones within the biliary tree post-cholecystectomy that may require removal by endoscopic retrograde Cholangiopancreatography (ERCP) or percutaneous cholangiography (PTC).