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Suggest treatment for gallstone removal - Online Doctor Chats

Date : 13-Dec-2014
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Very Good Posted in: Liver and Gall Bladder
Answered by

General & Family Physician
Practicing since : 2003
Answered : 1503 Questions
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User:Hi Doctor, My brother has gallstones (5mm) and is under medication..he badly would like to avoid a surgery
User:when the liver function test was performed, it showed Bilrubin 25.8 umol/L, however the doctor said this is since he has got the gallstone
User:He is worried and wanted to know if it is Jaundice
Doctor:Jaundice is a symptoms of a disease
User:He is currently taking rowachol (i guess to dissolve gallstones) and some tab for gastritis
Doctor:not a disease itself
Doctor:Does he have yellowish skin or eye discoloration?
User:However, he doesn't have any symptoms of Jaundice as such, like yellow skin/eye, vomiting
Doctor:Ok, well then, not jaundice
Doctor:Now, as far as avoiding surgery, it all depends
Doctor:if the stone does not block the outflow duct of the Gall Bladder..
Doctor:Then bile will flow normally
Doctor:and hopefully the rowachol will work and dissolve the stone
User:finger crossed
Doctor:if the stone (or stones) do end up blovking the outflow tract.. then surgery will be required
User:what should be diet he should follow while on medication? He is avoiding red meat and having vegetables
User:got it
Doctor:Unfortunately, there is very little we can do to predict the possibility. The bigger the stone.. the more likely it will block things
Doctor:Diet.. good question
User:the stone size is 5mm, not sure if this is considered as big
Doctor:More than anything, have him avoid fatty foods and foods with high levels of oil
Doctor:5mm is not that bad
User:is it ok to have fish and poultry?
Doctor:Fish and poultry are better than red meat.. but worse than a vegetarian diet in these cases
Doctor:I guess, in moderation, it should be OK
User:got it
Doctor:Also, alot depends on how the meart is cooked..
Doctor:fish may be very low in cholesterol.. but if you fry that fish in a ton of Ghee.. that is defeating the prupose
Doctor:He will need a follow-up scan in a few months and he will need to watch for jaundice and abdominal pain
Doctor:if these signs show up and persist, it may mean that the stone is blocking the outflow tract and surgery is required
Doctor:There is one other intervention other than surgery that could possibly be tried
Doctor:it is called an ERCP
User:He said he is a lot better now, but it appears some pain is there I guess during night
Doctor:Endoscopic retrograde cholangiopancreatography
Doctor:Basically an endoscope is used to enter the bile duct and place a ring and allow the stone to pass on its own
Doctor:It works better on smaller stones, but when it works... its great because surgery was avoided
User:understood (and it sounds better)
Doctor:So a good GI specialist can opine on whether he is a candidate for this.
Doctor:The other thing to remember is that minimally invasive surgeries have come a long way and cholecystectomy (the surgery he wants to avoid) is a pretty safe thing nowadays
Doctor:He would be in the hospital over the weekend at most
Doctor:Though, if I were him, i'd want to avoid surgery too..
Doctor:Do you have any more queries? Anything else I can help you with?
User:Great, thanks a lot for valuable answers. I appreciate your help
User:have a great day, I'll end the chat now
Doctor:Any time
Doctor:Thanks for visiting me here. Bye for now.
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