Question: My wife has been told that she has gallstones and has some pain just under her left ribcage. We don't want surgery. What is your suggestion?
Dr. Hibberd's Answer:
Left sided abdominal pain is not usually from gallstones or gallbladder problems, and should be properly evaluated. Inflammation or infection of the gallbladder usually presents with right upper abdominal pain.
Gallstones present risks for infection and obstruction of biliary drainage from the liver. Occasionally gallstones will also obstruct the pancreatic drainage system.
An exiting gallstone occasionally gets stuck, causing blockage to both drainage systems. Blockage of liver drainage may cause jaundice, while blockage of the pancreatic ducts may cause pancreatitis.
Pancreatitis is a very serious condition. Enzymes designed for digestion often get trapped and destroy parts of pancreatic tissue, occasionally creating what is called a pseudo-cyst.
Various degrees of success dissolving gallstones has been documented, but is by no means either rapid nor universally possible without side effects in some. Even if dissolution appears effective, the underlying tendency for formation of gallstones and sludge remains, so dissolution does little but postpone surgery.
Leaving gallstones in the gallbladder is known to significantly increase your risk for developing carcinoma of the gallbladder. For these reasons, the current standard therapy is surgical removal of the gallbladder. Stones that are not creating symptoms do not usually have to be removed immediately, but it is prudent to set up removal to prevent later problems.
Most patients can now have their gallbladders removed by scope instead of an open abdominal procedure. In experienced hands, this greatly decreases the risks of surgery and improves recovery time with less pain.
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