Can ERCP remove gallbladder stones?

Written by Jiang Zhen Hui
Hepatobiliary Surgery
Updated on September 27, 2024
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ERCP is currently being explored by some hospitals in China for the removal of gallstones. It involves inserting a tube through the lower part of the gallbladder to remove the gallstones. However, we generally do not recommend using ERCP for gallstone removal because if it becomes necessary to remove the stones, the gallbladder must be cut open, which can easily lead to complications such as suppurative cholecystitis. Currently, the most common method for removing gallstones is laparoscopic cholecystectomy, which, of course, requires mature surgical skills and relatively has fewer complications.

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Dietary Taboos for Gallstones

Patients with gallstones should primarily avoid spicy and irritating foods, such as chili peppers, barbecue, and garlic. They should adopt a light diet, eat more fresh vegetables and fruits, and also avoid foods high in cholesterol and fats, as these foods can exacerbate gallstone symptoms. Since most gallstones are cholesterol stones, patients with symptomatic gallstones should also undergo surgery as soon as possible. Only through surgery can a cure be achieved, which can significantly improve the patient's quality of life. Post-surgery, patients still need to be mindful of their diet to facilitate recovery.

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Radiology
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Gallbladder stones CT manifestations

Gallstones typically display characteristic features on a CT scan. Depending on the calcium content and the chemical composition of the stones, they can appear as high-density, isodense, or low-density stones. High-density stones present as multiple areas of increased density within the gallbladder, though they can also be solitary. A solitary high-density stone generally appears as a concentric circle with low central density surrounded by high density. Isodense stones have the same density as bile, which sometimes makes them difficult to distinguish. Low-density stones, which are primarily cholesterol stones, can sometimes contain gas, appearing as low-density shadows. CT is not the first choice for diagnosing gallstones; abdominal ultrasound is generally preferred.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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Gallbladder stones minimally invasive surgery, how long before getting out of bed?

How soon a patient with gallbladder stones can get out of bed and move around after minimally invasive surgery mainly depends on their recovery post-operation. For patients with gallbladder stones, the primary surgical method chosen is laparoscopic cholecystectomy. Due to the small incisions, minimal damage, and faster recovery associated with laparoscopy, it is often the preferred choice in clinical settings. Generally, patients can start moving around about five days post-surgery. However, in cases where patients have other underlying conditions, such as malnutrition, hypoproteinemia, or heart failure, the healing time may be extended. In such cases, it could take about half a month before they can move around. Therefore, the specific time when a patient can get out of bed and move around should be analyzed based on individual medical conditions.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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Do gallstones need to be removed?

Whether or not gallstones need to be removed depends mainly on whether there are symptoms and the size of the stones. For patients with gallstones smaller than four centimeters, they generally do not exhibit obvious symptoms and do not require special treatment. They can have regular follow-up ultrasound exams to dynamically observe any changes in the condition. Of course, they should avoid spicy and irritating foods in their diet to reduce inflammatory stimuli, which is beneficial in controlling the condition. For patients with larger gallstones, who repeatedly experience discomfort and pain in the upper right abdomen, it is necessary to remove the gallbladder through surgery to achieve a cure. The preferred method of surgery is laparoscopic cholecystectomy, as it has the advantages of a smaller incision, less damage, and quicker recovery.

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Hepatobiliary Surgery
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How should gallstones be treated?

The treatment of gallstones primarily depends on whether symptoms are present. For patients with relatively small gallstones, they usually do not experience significant discomfort and do not require special treatment. Regular ultrasonic re-examinations to monitor changes in size are recommended. Daily dietary intake should avoid spicy and stimulating foods, and foods high in cholesterol. For patients with larger gallstones, recurrent right upper abdominal pain and biliary colic may occur, so early surgical intervention is advised. Only through surgical removal of the gallbladder can a complete cure be achieved, with laparoscopic cholecystectomy being the main method of surgery.