Nonsurgical management of gallstone disease

Cholelithiasis is a common disease in the US associated with significant morbidity. Surgical treatment with cholecystectomy has been increasing with a significant cost to the health care system and is not without risk. Cholecystectomies are often performed unnecessarily in gallstone patients with nonspecific symptoms. Although cholecystectomy is the mainstay of gallstone treatment, nonsurgical treatment alternatives, such as bile acid therapy, topical dissolution, and extracorporeal shock-wave lithotripsy (if available) may be used in selected patients. Ln some cases, in particular in the elderly and in other patients at increased risk from surgery, nonsurgical management offers lower morbidity and mortality than does operative treatment.