Gallstones: Non-Surgical Treatment Options
Lithotripsy, or shock wave dissolution of gallstones, is a new procedure that uses a highly focused sound wave to break the stones into tiny particles which then pass through the cystic duct to the common duct and into the intestine.
The procedure, which takes about one hour, is done with general anesthesia or in some cases with mild sedation, and no incision is made. The patient lies flat on a table that has a bath of water beneath it. The physician uses ultrasound to locate the stones, and then focuses shock wave energy to break them up into small pieces. The patient takes the medication Actigall before and after surgery to dissolve the gallstone fragments.
In August 2001, Rhode Island Hospital became the second hospital in the United States to offer lithotripsy as a treatment for gallstones.
Does everyone with gallstones qualify for lithotripsy?
No. Patients must have cholesterol gallstones, no history of acute cholecystitis, pancreatitis or common duct stones, not more than three gallstones, total stone size less than 30 mm, a functional gallbladder by oral cholecystogram and no medical contraindications. About 10 to 15 percent of patients with symptomatic gallstones are eligible for lithotripsy.
Are there side effects?
Some patients experience abdominal pain immediately following lithotripsy, as the stone fragments begin to dissolve. Other side effects can include skin bruising, blood in the urine, upset stomach or fever, diarrhea or constipation, headache or dizziness. Although there is a risk of pancreatitis or common duct stones, it is rare-the chance is less than one percent. The overall treatment is 90 to 95 percent effective.
Once lithotripsy is performed do I need anything else?
Yes. After the lithotripsy treatment you need to take Actigall three times per day for about one year to aid in the dissolution of the gallstone fragments. In addition, it is a good idea to continue to take Actigall one time per day to prevent future gallstone formation. You still have a diseased gallbladder, with a 30 to 50 percent estimated chance of gallstone recurrence in 3 to 5 years.
More about Actigall and medication options
How much does lithotripsy cost?
Lithotripsy is a newly-approved procedure which may not be covered by some insurance companies. Check your insurance plan and consult your physician for details.