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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Laser Surgery Advisable To Remove Large Gallstones?

Hi, I am a 51 year old female who has large gallstones and I had my first consultation 10 years ago to have it removed...I have never had much pain, no attacks as they say, I suppose that is because the gallstones are too large to pass through the bile ducts, but now I have pain on the left side, have somewhat of a fatty liver and seem to not digest things very well without belching or feeling full. My question to you is...I know something has to be done, I have heard of Laser surgery to bust up the stones, Is this an option for me, especially, having large stones and having a gallbladder that if pretty well full....Thankyou for you response,
Mon, 11 Aug 2014
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Gastroenterologist, Surgical 's  Response
Hi,
How are you? I am so sorry to hear about your symptoms.
Stones in the gall bladder are a fairly common finding during USG of the abdomen. You do not need any additional tests to confirm the presence of gall stones. But not all gall stones need treatment. In most cases the stones do not cause any symptoms to the patient. This is especially true if there is a single stone. In some cases, when there is a small stone, it can spontaneously get expelled from the gall bladder. This is usually accompanied by pain and occasionally jaundice. The main danger of gall stones is when the stone blocks any of the ducts (tubes) draining bile. This scenario is more common when the stone is small enough to pass through the gall bladder opening but for some reason gets stuck in the bile duct. This will need a ERCP to extract the stone. This is much more common when the gall bladder has multiple small stones.
In 99% of the cases, the treatment is accomplished by "Laparoscopic Cholecysytectomy" (removal of gall bladder by making 3 small cuts on the abdomen, guiding the surgery through a small camera inserted). This is a fairly routine surgery and could be done at most hospitals safely. Unfortunately there are no medical therapies available once the stones have already formed.
Also laser therapy for stones have been utilised in kidney stones and not in Gall bladder stones and hence has no role.
In your case, (as I understand) there are multiple small stones. Since you are getting symptoms of pain, I would suggest to get the gall bladder removed at the earliest.

Hope this helps and please do not hesitate to contact me for more details - rxsuresh@gmail.com
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Is Laser Surgery Advisable To Remove Large Gallstones?

Hi, How are you? I am so sorry to hear about your symptoms. Stones in the gall bladder are a fairly common finding during USG of the abdomen. You do not need any additional tests to confirm the presence of gall stones. But not all gall stones need treatment. In most cases the stones do not cause any symptoms to the patient. This is especially true if there is a single stone. In some cases, when there is a small stone, it can spontaneously get expelled from the gall bladder. This is usually accompanied by pain and occasionally jaundice. The main danger of gall stones is when the stone blocks any of the ducts (tubes) draining bile. This scenario is more common when the stone is small enough to pass through the gall bladder opening but for some reason gets stuck in the bile duct. This will need a ERCP to extract the stone. This is much more common when the gall bladder has multiple small stones. In 99% of the cases, the treatment is accomplished by Laparoscopic Cholecysytectomy (removal of gall bladder by making 3 small cuts on the abdomen, guiding the surgery through a small camera inserted). This is a fairly routine surgery and could be done at most hospitals safely. Unfortunately there are no medical therapies available once the stones have already formed. Also laser therapy for stones have been utilised in kidney stones and not in Gall bladder stones and hence has no role. In your case, (as I understand) there are multiple small stones. Since you are getting symptoms of pain, I would suggest to get the gall bladder removed at the earliest. Hope this helps and please do not hesitate to contact me for more details - rxsuresh@gmail.com