Hi With USG scan, I came to know that there is 5 mm stone in my gall bladder. Is it suggestive to go for extracorporeal shock wave lithotripsy or laparoscopy for gall stone removal & what are the side effects involved in both the treatment. Kindly Suggest alternative therapeutic options without surgery.

Dr. Shriniwas DeshpandeGeneral Surgeon24yrs exp

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The symptomatic stones definitely need treatment. The standard treatment for stones in the Hall bladder is surgery. Minimal Invasive Surgery like Lap chole or laparoscopic surgery is the recommended procedure these days. ESWL is not useful for Gall bladder stones. (out of many reasons let me tell you why it is so. Reason: the stones in GB affects the proper contractility Of the GB. And good functioning organ is needed to flush out the small gravels which are the products of shock waves. Gravels passing over into the CBD may cause biliary colic, biliary pancreatitis or obstructive jaundice. Second reason is Gall Stone reform in presence of pathological Gall bladder) Lap Chole involves removal of GB through small keyhole type incisions. If the stones are present in the CBD as well, patient may be advised therapeutic ERCP. In cases where additionally CBD stones are suspected (on LFT profile) to be present EUS OR MRCP may help to evaluate the lower CBD. My recommendation for fit patient is to go for Lap Chole under general anesthesia.  

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