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Gallstones

How Are Gallstones Diagnosed?

If your doctor suspects you have gallstones, he or she will do a physical exam and may perform various other tests, including the following:

  • Blood tests: Blood tests may be given to check for signs of infection or obstruction and/or to rule out other conditions.
  • Ultrasound: This procedure produces images of various parts of the body and can be used to identify gallstones.
  • CAT scan: This test uses specialized X-rays to create cross-section images of organs and body tissues.
  • Cholescintigraphy (HIDA scan): This test can determine whether the gallbladder is contracting correctly. A radioactive material is injected into the patient and makes its way to the gallbladder. The technician can then observe the movement of the gallbladder.
  • Endoscopic ultrasound: This test combines ultrasound and endoscopy to look for gallstones.
  • Endoscopic retrograde cholangiopancreatography (ERCP): The doctor inserts an endoscope through the patient's mouth down to the small intestine and injects a dye to allow the bile ducts to be seen. The doctor can then remove gallstones that have moved into the ducts.

How Are Gallstones Treated?

Gallstones are usually treated with surgery to take out the gallbladder. The traditional operation is called an open cholecystectomy. A newer procedure, called laparoscopic cholecystectomy, is less invasive, has fewer complications, and is used more often.

  • Laparscopic cholecystectomy. During this procedure, instruments, a light, and a camera are passed through several small incisions in the abdomen. The surgeon views the inside of the body by looking at a video monitor. This procedure is used in approximately 80% of gallbladder removals. After the surgery, the patient spends the night in the hospital.
  • Open cholecystectomy. This is a more invasive procedure in which the surgeon makes incisions in the abdomen to remove the gallbladder. The patient stays in the hospital for a few days after the surgery.

If gallstones are in the bile ducts, endoscopic retrograde cholangiopancreatography may be used to find and remove them before or during gallbladder surgery.

Are There Any Nonsurgical Treatments for Gallstones?

If you have a medical condition and your doctor feels you shouldn't have gallstone surgery, he or she may prescribe the medications Actigall or Chenix. These drugs work by dissolving cholesterol stones. Mild diarrhea is a side effect of both medications.

The downside of using either medication is that you may have to take it for years to completely dissolve the stones. In addition, the stones may come back after you stop taking the drug.

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WebMD Medical Reference

Reviewed by Andrew Seibert, MD on September 19, 2012

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