Posts Tagged ‘ERCP’

Don’t throw the baby out with the bath water. Try to keep your gall bladder if at all possible. While it is not technically necessary to digest food, it is very helpful in proper digestion and nutrient absorption. Chances are that you WILL miss it (as the symptoms of not having one pile up), and once it is gone, it is gone forever.

The following is a chapter from my book, on gallstone treatments:

Gallstone treatments

If you are fortunate enough to have caught your gallstone problem before your gall bladder was ruined, you have a few options for treatment.


If this sounds familiar from the diagnostic list that’s because it is the same procedure involving the same equipment, only this refers to using it to treat the stones after they are found. ERCP or “Endoscopic Retrograde Cholangio-Pancreatoscopy” (say that 5 times fast!) can be used not only to assess the situation in your gall bladder but can be used to treat the problem as well. Using this procedure, some stones can be removed from the gall bladder or bile duct without the need for surgery. Basically the doctor runs a fancy endoscope down your throat and then up through the ducts from which your bile flows, and dissolves the stones with chemicals injected by the scope. With this procedure, you do not need to be opened up with knives, and the doctor will have a camera’s-eye view of the inside of your bile ducts and gall bladder, by which he/she can further assess just how bad the situation may be.

Bile Acid Supplementation:

Some stones can be treated with oral ingestion of bile acid. This has a roughly 75% rate of success on cholesterol-based stones, but 15% of the patients of this treatment still end up with recurring gallstones within 2-3 years.


The use of sonic shock waves, or Lithotripsy, to break up gallstones can be very effective . This treatment is good in that it does not require the patient to be anesthetized, however repeated treatments will be necessary to ensure that the stones have all been broken down into small enough pieces that they can be passed through the bile duct without getting stuck. Patients with a single large stone have much higher success rates than patients with multiple smaller stones. 95% of stones treated this way are passed within 12-18 months. This treatment does increase the risk of pancreatitis and gall bladder inflammation (acute cholecystitis) because the small pieces still need to pass through the bile ducts and can cause irritation along the way.

Contact Dissolution:

Another more meat-and-potatoes way to get rid of gallstones is “contact dissolution” which involves injecting chemicals directly into the gall bladder by way of a percutaneous catheter (a really long needle) to dissolve the stones. In cases with multiple gallstones, this method is the most effective, with a 95% success rate. MTBE (methyl tertiary-butyl ether) is commonly used as the solvent. Side effects are caused by the body’s absorption of the MTBE and can include vomiting, difficulty breathing, drowsiness, and bad breath. Of course you also have to deal with having a needle stuck into you for 5-12 hours for the treatment; Anesthesia, while preferable, is not mandatory. But you get to keep your gall bladder.