Dissolution of gallstones without surgery. How to get rid of gallstones without surgery: methods of treatment and removal by dissolution How to cure gallstones without surgery

Gallstone disease is a general somatic disease caused by the formation of stone-like formations (calculi) in the gallbladder, ducts as a result of a violation of the biomechanisms of certain metabolic reactions. The incidence of the disease ranges from 10% for the adult population to 30% for the elderly and senile.

The disease develops for a long time - for several years, during which a polymorphic symptomatic picture is observed. To remove stones, conservative methods are used (drug dissolution, crushing by shock wave or laser exposure). In advanced cases, the removal of stones is carried out through surgical intervention.

Causes of stone formation in the gallbladder

The main factors causing the onset and further development of pathology are the production of bile supersaturated with cholesterol, a shift in the equilibrium balance between the activity of antinucleating and pronucleating biocomponents against the background of a deterioration in the contractility of the gallbladder.

This problem may be the result of various autoimmune diseases (diabetes mellitus, hemolytic anemia, granulomatous colitis, various forms of allergies, liver cirrhosis, and others). However, the most likely causes of the formation of calculi are the following:

The presence of inflammation in the bile ducts, bladder.
genetic predisposition.
Hemicolectomy (total or subtotal).
Obesity.
Postponed surgical operations on the organs of the digestive tract.
Dyskinesia (functional disorders of motility) of the biliary tract.
periods of pregnancy.
An unbalanced nutritious diet, which is based on cholesterol-containing foods, poor in plant fibers.
Lesions of the hepatic parenchyma, characterized by infectious-toxic etiology.
cholesterosis.
Sudden weight loss, starvation.
The presence of a syndrome of impaired absorption.
Taking certain medications (including oral contraceptives).
Cholecystitis (xanthogranulomatous, chronic forms).
Age changes.
Violations of the functions of the endocrine system.
Sedentary lifestyle, hypodynamia.

Stone formation in the cavity of the bladder and bile ducts can be provoked by mechanical causes: the presence of tumor-like neoplasms, adhesions, edema, narrowing and kinks of the ducts. In addition, the presence of congenital anomalies is not excluded - cysts of the main bile duct, diverticulum of the duodenum.

Symptoms of gallstones

For cholelithiasis initially (the first 4 - 8 years) is characterized by an asymptomatic course. The time of onset of symptoms and its intensity depend on the size of the stones, their type, number and location.

The main sign indicating the presence of stone-like structures is hepatic colic - a pain syndrome felt in the right hypochondrium and often radiating to the right shoulder blade, shoulder, lumbar region, and chest. Manifested due to the use of alcohol-containing drinks, high-fat foods. Often observed as a result of psycho-emotional or physical stress. The duration of the pain attack is 4-6 hours. The presence of stone-like formations is also indicated by symptoms:

Vomiting containing bile.
Intestinal disorders (constipation, diarrhea, flatulence).
An increase in temperature to subfebrile indicators (37.1 - 37.8 degrees).
Discoloration of feces.
Increased fatigue, general weakness.
Loss of appetite.
Obstructive jaundice.
Presence of a bitter taste in the mouth.
The appearance of a white or brown coating on the surface of the tongue.
The manifestation of pain during palpation of the cystic points.
Detection of neutrophilic leukocytosis, eosinophilia.
The manifestation of pain in the process of driving on uneven road surfaces.
Individual intolerance to certain products.

Advanced cases are characterized by cholecystocardial syndrome, which manifests itself in the form of paroxysmal or aching pains localized in the region of the apex of the heart. Perhaps the appearance of pain in the joints, neurasthenic syndrome. With complete blockage of the ducts, fever, convulsive spasms, and increased sweating are observed.

Diagnosis of gallstone disease

To detect the disease, 2 types of methods are used - laboratory and instrumental. Laboratory studies include the collection of biochemical and general blood tests. In the presence of stones, there is an increase in the activity of aminotransferases, an increase in the level of leukocytes, bilirubin and erythrocyte sedimentation rate.

The main instrumental method is ultrasound, which allows to establish the state of the organs of the biliary system, the presence of inflammatory processes in them, as well as the exact localization of stones, their size and number. Additional diagnostics are possible in the following ways:

Percutaneous transhepatic cholangiography is a contrast antegrade examination of the biliary tract by blind percutaneous puncture of the liver.
Endoscopic ultrasonography is an ultrasound study of pathology using a medical endoscope inserted inside through the esophagus. It is prescribed in the presence of obesity, flatulence.
Cholecystocholangiography - the creation of an x-ray image of the ducts and bladder. Requires oral or intravenous administration of radiopaque iodine-containing compounds into the body. Used before laparoscopy.
Radiography - obtaining an overview image of the upper abdominal cavity in order to detect calcifications.
Endoscopic retrograde cholangiopancreatography is a method that requires the introduction of radiopaque substances into the ducts using an endoscope and provides for further examination of the biliary tract and bladder through an x-ray machine.

Detection of large stones is possible through palpation. Diagnosis and appointment of appropriate therapy is carried out by a gastroenterologist. If there are indications for surgical methods of treatment, a full-time consultation with a surgeon is required.

Types of stones in the gallbladder

Stones that form in the biliary system are divided into primary and secondary. The first type is formed in the cavity of the bladder for a long time due to changes in the structural composition of bile. The disease in this case does not show obvious symptoms.

Secondary stones occur when there are violations of the outflow of bile: with cholestasis, biliary hypertension, as a result of clogging of the ducts by previously formed primary calculi. They can be localized in the bladder, ducts. In addition, stones are classified according to the following types:

Lime. Appear with inflammatory phenomena that affect the walls of the gallbladder. Cholesterol crystals, pathogenic bacteria or scales of desquamated epithelium act as the core of this type of calculus.
Cholesterol. Represented by rounded homogeneous structures, reaching 1.8 cm in diameter. Arise as a result of violations of metabolic reactions and are found in the cavity of the bladder in obese people.
Bilirubin, or pigment. Like the previous species, they are non-infectious in nature. They are formed as a result of changes in blood proteins or in the presence of congenital pathologies that accelerate the destruction of red blood cells. These stones are localized in the cavity of the bladder, ducts and are characterized by small sizes.
Concrements of mixed composition. They are formed on the basis of pigment or cholesterol stones due to the layering of calcifications on the main core. These processes occur against the background of the development of inflammatory phenomena.

The size of the stones can vary in a wide range - from 2 - 3 mm to 4 - 5 cm, the consistency - from waxy to hard, the configuration - from spherical to irregular shapes. The weight of one calculus is from 0.5 g to 80 g.

Treatment of gallstones without surgery

Conservative methods are effective in identifying the initial stages of the disease, in the presence of small stony formations (less than 1 cm in diameter). Such methods eliminate the need for surgical intervention, and make it possible to preserve the ducts and the organ itself.

What to do if stones are found in the gallbladder? It is possible to eliminate calculi through drug therapy, ultrasonic destruction of the nuclei of stones, or alternative medicine methods. However, any chosen method of treatment should be carried out under strict medical supervision.

Dissolution of gallstones

To dissolve the formed stones, oral litholytic therapy is used, which involves the administration of drugs based on chenodeoxycholic and ursodeoxycholic acids. Such drugs contribute to a change in the structural composition of bile: a decrease in cholesterol and an increase in the level of bile acids. Medical treatment is recommended under the following conditions:

Preservation of normal contractility of the gallbladder in combination with good patency of the bile ducts.
The predominance of cholesterol stones.
The size of the stones does not exceed 1.5 cm, provided that they fill only half the volume of the bladder cavity.
The possibility of taking drugs for a long period.

The duration of therapy is from six months to 2 years. Treatment should be accompanied by a refusal to use drugs that promote stone formation (antacids, cholestyramine, estrogens). The method is contraindicated for people with diseases of the digestive and urinary systems. The efficiency of removing stones by this method is 45 - 78%, the probability of recurrence in this case reaches 72%.

Crushing stones in the gallbladder

Mechanical destruction of stones is carried out by means of extracorporeal shock wave lithotripsy. It is often used before the appointment of drug dissolution of stony formations. The principle of the method is based on the use of an ultrasonic wave, under the influence of which the calculi disintegrate into small fraction stones. A laser can be used for the same purpose. Indications for the procedure:

No blockage of the bile ducts.
Stone diameter less than 3 cm.
The presence of stones of cholesterol origin without admixture of calcifications (up to 5 pieces).

Crushing is carried out in several stages: depending on the number and size of stones, 1-7 sessions are required, after which the removal of crushed stones occurs naturally through the biliary system. The procedure is prohibited for patients with bleeding disorders and people suffering from chronic diseases of the digestive tract. This is associated with the risk of blockage of the ducts and possible damage to the integrity of the walls of the main organ of the biliary system, which can cause inflammation and the formation of adhesions.

Folk remedies for removing stones from the gallbladder

The use of traditional medicine recipes requires a mandatory medical consultation and is carried out only after identifying the size of the stones, their number and location using an ultrasound or x-ray examination. The following tools are well-deservedly popular:

Sauerkraut juice. Used three times a day for 2 months. A single dose of a drink is 100 - 180 ml per dose.
Rowan fruits. You should eat 250 - 300 g of fresh berries daily. The product can be eaten in combination with honey, bread, sugar. The duration of treatment is 1.5 months.
Infusion of lingonberry leaves. 1 st. l. leaves are brewed with 180 - 200 ml of boiling water, kept for half an hour and filtered. A decoction is used up to 5 times a day at a dose of 2 tbsp. l. for the reception.
Olive oil. It is taken orally on an empty stomach for 0.5 tsp. Gradually, a single dosage should be increased to 100 ml. The duration of the course is 3 weeks.
Beet syrup. Fresh vegetables (3 - 5 pieces) are peeled and boiled for a long time until syrup is formed. The resulting liquid is used three times a day for 70 - 100 ml.
Decoction of birch leaves. 1 st. l. dried vegetable raw materials pour 200 ml of boiling water and simmer for 20 minutes over moderate heat. The resulting extract is wrapped and infused for 1 hour, then filtered through a piece of gauze. The drug is taken on an empty stomach at a dose of 200 ml.

A prerequisite for the use of alternative medicine is the absence of allergic reactions to the components that make up the formulations. During the course of treatment, you need to pay attention to well-being. If the condition worsens, the medication should be discontinued.

Surgical treatment of gallstone disease

Treatment with surgical methods is recommended when large stones are found, frequent relapses of the disease, accompanied by fever, intense manifestations of pain, and the occurrence of various complications. The operation is performed by laparoscopic or open method.

Removal of the gallbladder entails the occurrence of various diseases of the digestive system, which is associated with a deterioration in the digestibility of food. Therefore, surgical methods are resorted to in cases where conservative treatment has been ineffective. Surgical treatment options:

Classical cholecystectomy - removal of the bladder with calculi through abdominal surgery. The main disadvantages of the technique are injury to a large area of healthy tissue when creating an incision (the length is from 15 to 20 cm) and a high risk of developing complications of varying severity.
Laparoscopic cholecystectomy - removal of an organ using a specialized laparoscope apparatus, performed through small incisions (about 1 - 1.5 cm long). This method is considered sparing, as it helps to prevent the formation of noticeable scars and significantly shorten the rehabilitation period.
Laparoscopic cholecystolithotomy is an organ-preserving surgical procedure that involves the extraction of formed stones.

Surgical treatment requires advance preparation of the patient: taking appropriate tests, considering possible risks, evaluating expected results to minimize possible complications. In case of deviations of analyzes from normal indicators, preliminary treatment is necessary in order to improve the general condition.

Diet and nutrition for gallstones

Diet in the case of gallstone disease is of fundamental importance. In this case, fractional nutrition is recommended, which provides for eating at least 5 times a day, which stimulates the outflow of bile produced and prevents its stagnation.

The food consumed should contain the amount of animal proteins, vegetable fats, essential microelements (primarily magnesium) necessary for the body. Products that have a beneficial effect on the biliary system:

Vegetables: carrots, cauliflower, pumpkin, zucchini.
Meat and fish of low-fat varieties: beef, rabbit meat, veal, chicken, river fish.
Dairy products with low fat content: milk, curd products, cheese, butter (as an additive to cereals).
Cereals: buckwheat, oatmeal, rice, millet, semolina.
Fruits and dried fruits: watermelon, apples, grapes, prunes.
Juices, fruit drinks, compotes: quince, pomegranate, bird cherry, blueberry.
Chicken eggs (if tolerated).

The diet should not include fatty foods and offal (meat, fish), canned food, spicy, sour, salty, fried foods, pastries from pastry, caffeinated and alcoholic drinks. In the presence of stones, vegetables with a high content of essential oils (turnip, garlic, radish, onion, radish) and oxalic acid (spinach, sorrel) should be strictly limited or excluded from the diet.

Possible complications of gallstone disease

The lack of timely diagnosis and appropriate treatment of cholelithiasis can cause the development of various complications (including severe diseases and their transition to a chronic form):

Phlegmon of the bladder wall.
Cholecystitis.
Pancreatitis (biliary form).
Dropsy.
Cholangitis.
Empyema of the gallbladder and, as a result, its gangrene.
Intestinal obstruction.
Oncological diseases of the biliary system.
Bladder perforation.
The formation of biliary fistulas.
The occurrence of Mirizzi's syndrome.
Rupture of the walls of the bladder with the subsequent development of peritonitis.
Toxic hepatitis.

In the case of the development of one or another complication, the appointment of appropriate treatment is required, which is carried out in parallel with the treatment of gallstone disease. In severe cases, in the absence of adequate therapy, a lethal outcome is not excluded.

Prevention of the formation of stones in the gallbladder

The simplest and most effective way to prevent the formation of stones is to follow preventive measures. The main measures in this case are maintaining a healthy lifestyle and compiling an optimal diet. In addition, tyubazh is useful, which can be carried out at home.

To prevent recurrence of the disease (re-formation of stones), it is recommended to continue oral litholytic therapy for a long period (up to 1 year). In addition, the following measures are effective:

Refusal of food, characterized by a high content of cholesterol, animal fats, or severe restriction of the use of such products.
In the presence of obesity, a gradual decrease in body weight to optimal parameters is recommended, which is possible through a low-calorie diet and regular exercise.
Avoiding prolonged periods of fasting.
Cessation of taking a number of drugs that contribute to the processes of stone formation (if any).
The appointment of medications (Liobil, Zixorin), which reduce the body's production of cholesterol and stimulate the synthesis of bile acids.

Fractional nutrition, which involves the use of small portions every 3 to 4 hours, as well as the daily intake of vegetable fats (about 2 tsp of vegetable oil per day), significantly reduces the likelihood of stones in the biliary system and the development of concomitant diseases.

The appearance of stones in the gallbladder is a consequence of disorders in the metabolism of bilirubin or cholesterol.

This condition can lead to negative consequences - inflammation of the affected organ, frequent colic and even peritonitis.

Therefore, the dissolution of stones in the gallbladder with folk remedies is considered a very topical issue.

Reasons for the appearance of stones

The following factors contribute to the development of gallstone disease:

insufficiently active lifestyle;
eating disorders;
wearing corsets and slimming belts;
taking certain medications;
genetic predisposition.

The reasons for the formation of stones include such violations:

excess weight;
viral hepatitis;
pathology of the nervous system;
the formation of kidney stones;
sand in the urine;
gout;
diabetes.

Symptoms

Quite often, gallstone disease is not accompanied by pronounced manifestations. Even with the impressive size of the stones, it can be asymptomatic.

Often, pathology is detected only when performing x-rays or ultrasound.

Sometimes with the appearance of stones in the gallbladder, the following symptoms appear:

colic under the ribs and in the epigastric zone;
flatulence;
nausea;
vomit;
exit of gases from the oral cavity;
bitterness in the mouth;
increase in temperature;
high fatigue;
loss of appetite.

Folk methods of treatment

The dissolution of stones in the gallbladder without surgery is carried out using folk recipes. Even with the help of ordinary infusions and decoctions of herbs, it is possible to soften the stones and try to remove them.

It is important to consider that such methods help to cope with only small particles.. They can only be used after an ultrasound examination. Otherwise, there is a risk of dangerous consequences.

The dissolution of stones in the gallbladder according to Bolotov involves the use of chicken bile. To do this, you need to buy a fresh chicken carcass and carefully cut out the gall sac. Draw its contents into a syringe.

Since bile has a bitter taste, it is consumed with bread.. To do this, you need to roll up small balls of bread crumb, make indentations in them and add 2 drops of bile. Then roll the ball again so that the bitter product is inside.

Such a remedy should be taken at regular intervals - after 2 hours. The course of treatment is 1 month. Some patients require less time.

After 2 weeks of therapy, it is worth doing an ultrasound to evaluate the results.

Chicken gizzards

To dissolve the stones, you need to buy chicken stomachs, rinse and cut off the films. Then they must be dried, ground to a state of flour and sifted through a sieve.

The resulting powder should be consumed in the morning 1 hour before breakfast in the amount of 1 small spoon. It is recommended to drink the product with milk or water.

The duration of therapy depends on the size and number of stones. Most often, the remedy is used in courses lasting 21 days. Between them you need to take 20-day breaks.

During the period of therapy, it is necessary to completely abandon fatty and fried foods.

Take 1 kg of nuts along with the shell and pass through a meat grinder several times so that the mixture is very fine. Then add 500 ml of medical alcohol.

Separately, you need to prepare sugar syrup by mixing sugar with water in equal proportions. When the composition has cooled, it must be added to the nuts. The product must be infused for 15 days in a glass container.

The result is a thick dark mass. It is taken after meals, 1 small spoonful. It is advisable to mix everything thoroughly before use. For a course of treatment lasting 2 months, 3 kg of nuts will be required.

Potato

Take 1-1.5 kg of fresh potatoes, wash thoroughly. Peeling vegetables is not recommended.. Put in a container with 6 liters of water and simmer for 3 hours. Prepare a liquid puree, salt and cool.

When the potatoes have settled, drain the liquid into a jar and store with the lid closed. It is recommended to do this in a cool place.

Take a decoction of 2 tablespoons half an hour before meals. This must be done three times a day. The course of therapy is 1.5 months. Thanks to the use of this tool, it will be possible to remove stones and sand.

Olive oil is considered an effective remedy.. This product contains fats that are highly digestible. Thanks to its use, it is possible to cleanse the body of excess bile.

The tool has a pronounced choleretic effect and prevents congestion and inflammation. Thanks to its use, it is possible to reduce the amount of cholesterol and prevent the formation of solid particles.

It is best to use virgin oil. You need to start taking it with half a small spoon. Gradually increase the dosage - preferably up to 1 cup. This therapy should be continued for 2-3 weeks.

Black radish

Black radish juice has pronounced choleretic characteristics. Thanks to its use, it is possible to get rid of small particles, sand and stones.

To solve these problems, you should take 2-3 tablespoons of this product every day. This must be done before meals.

Under the condition of normal juice tolerance, the dosage is gradually increased, bringing it up to 100 ml. After 1 month, you can take 2 glasses of the drug. The product can be mixed in equal parts with honey.

Beet

This product perfectly helps with inflammatory damage to the organ and the formation of stones. It can help reduce cholesterol levels.

Beets can be used in the form of juice or decoction..

To prepare the product, the vegetable must be boiled, chopped and squeezed. Bring the resulting liquid to a boil and heat until it thickens.

Take a quarter cup three times a day. Gradually, the stones will dissolve, which will facilitate their painless removal.

Dandelion

The fresh leaves of this plant help to break up the solid particles that are in the gallbladder..

To do this, you need to collect 2 bunches of leaves, squeeze a tablespoon of juice from them, add a small amount of water and consume twice a day 30 minutes before meals. The course of treatment is 2 months.

You can also put fresh leaves in a salad.. Phytotherapists advise during flowering to use 5-6 stems of the plant per day. They are recommended to be cut near the ground itself.

Dandelion stems should be thoroughly washed, cut off the flowers and consumed raw with water.

To prepare this remedy, you will need a bay leaf in the amount of 300 pcs. You also need to take 10 tablespoons of honey and 1 liter of water.

Mix all the ingredients in an enamel saucepan and heat to reduce the amount of liquid by half.

Strain the resulting composition and drink warm at night. Drink half a glass at a time.

Corn silk

This product has pronounced choleretic properties.. To prepare the infusion, you need to take corn stigmas in an amount of 10 g, add 250 ml of boiling water and put in a steam bath for half an hour.

Then cool and strain. Add water to get 200 ml. Take a quarter cup half an hour before meals.

Sunflower roots are considered another effective remedy, which helps to dissolve even fairly large stones.

To make a useful product, you need to take 1 cup of dry chopped roots, add 3 liters of water and cook for 5 minutes.

Then leave the agent to infuse. Use 1 liter of decoction per day.

Used roots should not be thrown away.. Of these, you need to make a decoction by adding 3 liters of water. In this case, it is recommended to boil the product for 10 minutes.

The third time, the roots are boiled for 20 minutes. The fourth time you need to take a new portion of raw materials. Treatment with this remedy should be continued for at least 1 month.

Herbalists advise using a variety of herbs to dissolve gallstones. They allow you to cope with stagnation of bile, spasms, inflammation. Such products remove small stones and remove sand.

The most effective plants include the following:

The Konovalov method is considered an effective method of treatment.. The specialist advises first of all to get rid of the cause of the pathology.

To do this, you need to give up fried and fatty foods, reduce the consumption of foods with cholesterol. To normalize the excretion of bile, choleretic herbs should be used.

Special gymnastics helps to cope with stones in the gallbladder. The most useful exercises include movements for training the abdominal muscles. You also need to perform retraction and protrusion of the abdomen, turns and tilts of the body.

Breathing exercises are considered to be an excellent tool, which affects the abdominal muscles. For example, you can do this exercise every day: sit on a chair, put your legs together, straighten your back and relax, and then take a long breath while pulling in your stomach.

Hold your breath for 10 seconds. Then, exhaling slowly, stick out your stomach. After a short pause, you need to inhale again. Repeat this cycle 30-40 times.

Massage is considered the best diagnostic method. In addition, it helps to eliminate disorders in the gallbladder.

It is important to consider that this procedure can only be performed by a specialist. Otherwise, there is a risk of worsening the patient's condition.

Diet

Many patients are interested in what foods help dissolve stones.. To cope with the problem, you should definitely review your diet. Only an integrated approach helps to get rid of stones without surgery.

The gallstone dissolution diet aims to reduce fat intake. Its amount should not exceed 65-90 g. At the same time, you need to eat more carbohydrates - up to 345 g per day.

Experts advise including chicken, vegetable soups, fish, low-fat dairy products in the diet. A useful tool in the formation of stones is dill.. This green should be consumed systematically.

It is not recommended to eat egg yolks, spices, coarse foods. Banned fresh bread, coffee, mayonnaise, chocolate, carbonated drinks. To cope with the problem, you need to eat foods that are steamed or baked in foil. Stews are also acceptable.

From fruits you can eat apples, bananas, pears, strawberries, citrus fruits, blackberries. In this case, it is better to refuse plums, nuts, almonds, currants. Compotes should be prepared from fruits, as they are well absorbed by the body.

The appearance of stones in the gallbladder is a fairly common problem that can cause dangerous complications.

To cope with the disease, you need to see a doctor in a timely manner. As an addition to traditional therapy, effective folk recipes can be used.

It occurs quite often and modern medicine offers more than one method of treating this disease. Drug treatment does not always bring the desired result, so in such cases I resort to a more radical method - crushing stones in the gallbladder.

Gallstone disease is a disease in which stones form in the gallbladder.

Cholelithiasis (gallstone disease) is a pathology in which stones form in the gallbladder or duct. The size of the stones can be from a couple of millimeters to several centimeters.

The reasons for the formation of the disease include the intake of products in which there is a high content of animal fat and protein. Due to the uncontrolled use of these products, a person’s cholesterol level in bile goes off scale, which leads to poor performance of functions and stagnation.

Bile is a fluid found in the gallbladder cavity that is responsible for the breakdown and digestion of food. The gallbladder is located next to the liver, which produces the production of bile, namely its component - the pigment bilubin. The second main component of the bile fluid is cholesterol, the excess of which provokes the development.

Due to the long stagnation of bile, cholesterol precipitates, from which the so-called "sand" is formed, the particles of which join each other and form (calculi). Stones of small size (1-2 mm) are able to pass through the bile ducts on their own, while larger ones are already a cholelithiasis that requires therapeutic intervention.

Symptoms of cholelithiasis

Heartburn can be a symptom of gallstone disease.

Often, a person is not aware of the presence of cholelithiasis until the sharp manifestations of symptoms that require urgent action. List of common symptoms of this disease:

acute pain in the place of the right hypochondrium;
a sharp attack of biliary colic;
nausea and vomiting;
elevated temperature;
yellowness of the skin.

The neglect of the disease can provoke the following complications:

infection of the gallbladder;
narrowing of the bile ducts;
the formation of chronic inflammatory processes leading to diseases such as hepatitis, cholecystitis, duodenitis,.

Methods of treatment of cholelithiasis

Laser crushing of stones is a method of treating cholelithiasis.

Modern medicine practices the following methods of treatment of gallstone disease:

Methods that do not require surgical intervention:

dissolution of stones with the help of medicines;
treatment with ultrasonic remote lithotripsy.

Methods with minimal intrusion:

crushing stones with a laser;
contact chemical litholysis.

Methods requiring surgical intervention:

laparoscopy;
open abdominal operation;
endoscopic cholecystectomy.

Before choosing the necessary treatment, you need to determine the composition of the stones. By nature of origin, they are: lime, cholesterol, pigment and mixed. Cholesterol stones can dissolve under the action of bile acids (ursodeoxycholic, chenodeoxycholic).

If this is not enough, then it is necessary to crush the stones with ultrasound or a laser, and only then apply acids. Despite the abundance of sparing methods for removing stones, the method of cholecystectomy is still actively used. This definition means removal along with stones. But gradually such operations are replaced by the endoscopic method of removal.

Dissolution of stones with medications

Allochol is a drug that stimulates the production of bile fluid.

This method of treatment is effective only for cholesterol stones, with calcareous and pigment stones, alas, this method does not work. The following medications may be used:

Bile acid analogues: Henofalk, Henohol, Ursosan, etc.
Drugs that stimulate the contraction of the gallbladder and the production of bile fluid: Holasas, Allochol, Liobil, Zixorin, etc.

Disadvantages of drug therapy:

when you stop taking medications, often (10-70% of cases) there is a repeated return of the disease, since the level of cholesterol again rises strongly;
side effects are observed in the form and changes in liver tests (AST, ALT);
the course of treatment is long, medication is taken for at least half a year, sometimes up to three years;
the high cost of medicines.

Contraindications to medical treatment:

diseases of the gastrointestinal tract: peptic ulcers,;
kidney disease;
obesity;
period of pregnancy.

Crushing stones with a laser

Stone crushing can be done with a laser.

This procedure is not long, it takes about 20 minutes. The anterior abdominal wall is punctured, then the laser beam is directed to the required area of the gallbladder and the stones are split.

Cons of laser crushing:

in this way, the walls of the gallbladder can be damaged, injuring them with sharp stones;
possible abstruction of the bile ducts;
a high probability of getting a burn of the mucous membrane, which can later lead to the formation;
professional equipment required.

Contraindications:

the patient's body weight is higher than 120 kg;
the patient is in serious condition;
You can not carry out the procedure for people over 60 years old.

Crushing stones with ultrasound

Crushing of stones by ultrasound is used if the patient has no more than four stones.

This method is used if the patient has no more than four stones, up to 3 cm in size, not containing lime impurities.

The principle of operation consists in exposing stones to high pressure and vibrations of a regenerated shock wave in order to crush the formed stones to a size not exceeding 3 mm.

there is a possibility of blockage of the bile ducts due to vibration waves;
sharp stones can damage the walls of the gallbladder.

Contraindications:

poor blood clotting;
period of pregnancy;
inflammatory processes and chronic diseases of the gastrointestinal tract: pancreatitis, peptic ulcers,.

Method of contact chemical cholelitholysis

This method fights with all types of stones, regardless of composition, quantity and size. The primary goal of contact chemical cholelitholysis is to preserve the gallbladder. The method can be applied at any stage of a symptomatic or asymptomatic disease.

How the procedure is carried out: with the help of control, a catheter is inserted into the gallbladder through the skin and liver, through which a dissolving liquid (mainly methyl trebutyl ether) is slowly introduced. Experts have confirmed that the gallbladder is resistant to the cytotoxic effects of this solvent.

The disadvantages of this method include invasiveness (intrusion into the patient's body).

Laparoscopy method

Laparoscopy is a method of dealing with stones in the gallbladder.

Doctors resort to such methods if a patient is diagnosed with such a diagnosis as calculous cholecystitis. The operation takes approximately an hour. Stages of operation:

general anesthesia is introduced;
a cut is made in;
the abdominal cavity is filled with carbon dioxide;
a tube is inserted into the incision to transfer the image to the monitor of the device;
the surgeon looks for stones and removes them with metal conductors (trocar);
staples are applied to the ducts and vessels of the gallbladder.

After the operation, you need to be under observation for about a week. Contraindications:

the stones are unacceptably large;
obesity;
gallbladder abscess;
heart diseases;
diseases of the respiratory system;
the presence of adhesions after other operations.

About stones in the gallbladder - in the thematic video:

Cholecystectomy and laparoscopic cholecystectomy

Laparoscopy and laparotomy in this case means the removal of the gallbladder along with the stones contained in it. A laparoscope is a tube with a video camera that is inserted into one of several incisions in the abdominal cavity (3-4 of them are made during the operation). Next, the gallbladder is removed through a small hole (up to 1.5 cm in diameter). Advantages of laparoscopy:

short recovery period;
low cost;
no big scars.

open open surgery

In the presence of too large stones, a surgical operation is performed.

Surgeons resort to this method for cholelithiasis with severe complications, for too large stones or in the presence of dangerous inflammatory processes.

The operation is performed through a large incision with a diameter of up to 30 cm, passing from the navel to the navel. Flaws:

compulsory anesthesia;
high invasiveness;
the possibility of infection;
risk of bleeding;
death is possible (with emergency surgery).

Reasons not to remove the gallbladder:

violation of motility of the muscles of the duodenum;
bile changes its consistency and does not effectively protect the organ from pathogenic organisms;
bile acid irritates the mucous layers and, as a result, diseases are possible: gastritis, colitis, etc.;
the functions of secondary absorption of bile are violated and it is quickly excreted from the body, which negatively affects the digestion process;
the appearance of pain in the right hypochondrium, bitterness and a metallic taste in the mouth.

Removal of the gallbladder does not guarantee the absence of cholelithiasis, since stones can also form in the bile ducts.

Before resorting to cholecystectomy, you need to try to get rid of the problem with more gentle methods, and only when their ineffectiveness is confirmed, then operate.

Products that remove excess cholesterol:

buckwheat and oatmeal;
low fat;
lean meat and fish;
still water, compotes, fruit drinks (at least 2 liters per day);
fruits vegetables.

Gallstone disease is accompanied by the formation of calculi (stones) from bile pigments, lime salts and cholesterol.

Among the ailments that affect the organs of the gastrointestinal tract, this pathology is one of the most common and dangerous for its consequences.

This explains the rapid increase in the number of operations to remove the gallbladder. But is surgical intervention always necessary for this disease, or is it possible to adhere to the tactics “if the stones do not appear, it is better not to touch them”?

To opt for one of the options, it will not be superfluous to familiarize yourself with the reasoning on how to dissolve stones in the gallbladder.

Briefly about the disease

The organ under discussion is a store of bile, which is necessary for the normal digestive process.

There are many factors contributing to the negative change in its biochemical composition. This is the excessive use of medications, excessively high-calorie foods, the lack of the necessary physical activity of a person.

As a result, it thickens and stagnates in the bladder and bile ducts (ducts), resulting in the formation of cholesterol clots, their gradual transformation into stones.

This becomes the main cause of gallstone disease, in which inflammatory and infectious processes develop in the gallbladder itself, cholecystitis, pancreatitis.

Blockage of the bile ducts caused by stagnation of bile and stones can cause a rupture of the bladder, which will inevitably lead to peritonitis, the need for surgery to remove it, and even death.

Symptoms

In order not to start the pathological process and start treatment in time, it is necessary to familiarize yourself with the first signs of a developing disease. It:

feeling of heaviness and pressure in the right hypochondrium;
frequent constipation;
bitterness in the mouth;
painful colic in the region of the liver.

If the stone is mobile, it can block the flow of bile from the bladder and cause a severe attack. In this case, there are intense pain girdle character.

To delay in such a situation is dangerous, you need to urgently be examined and undergo appropriate treatment.

Options for getting rid of stones

In addition to laparoscopic surgery, which is the most common method for removing stones, there are other ways to get rid of them.

Treatment without surgery

Traditional medicine has conservative methods for the treatment of gallstone disease. Among them, well-established:

Litholytic therapy

In this case, bile acid preparations are prescribed in tablets - Ursohol, Henohol, Ursosan, Henofalk. This option of stone dissolution is used when cholesterol stones no larger than 1.5 cm are detected. It is not suitable for getting rid of pigment gallstones and for patients who are prone to obesity.

The second type of drugs used in litholytic therapy is Ziflan. The immortelle included in its composition dissolves cholesterol stones.

Contact dissolution of stones

It involves the administration of methyl tertiary butyl ether (MTBE) directly into the gallbladder. It should be noted the complexity and insecurity of this procedure. It is carried out in the clinic under the supervision of experienced professionals.

Everything goes fast. Ether, remaining in a liquid state under the influence of the patient's temperature, contributes to the dissolution of stones in 6-10 hours. Staying in the clinic is caused by the possibility of serious side effects, which are accompanied by intense pain and burning.

shock wave therapy

The method is rarely used and often with the simultaneous use of litholytic therapy. The second name is “lithotripsy”. During the procedure, large stones are crushed by sound waves into small fragments. The use of the method is allowed in the presence of formations no larger than 2 cm in size.

The disadvantage of such techniques is the possibility of the formation of new stones. That is why removal by laparoscopic surgery is the main method of traditional medicine in this case.

The described methods of crushing and dissolving gallstones are used in a situation where surgical intervention is contraindicated for the patient.

Alternative ways

The expediency of removing stones in a non-surgical way is justified only if they are the result of an excess amount of cholesterol. In this case:

You can dissolve the formed cholesterol stones with herbal remedies. Rovachol is the best representative of herbal products. The course of treatment is 6 months. During this period, the calculi dissolve by improving the secretion of bile and reducing the production of cholesterol by the liver.
Acupuncture. With the help of acupuncture, it will not be possible to dissolve or remove gallstones. It is used to alleviate the condition: it relieves spasms, eliminates stagnation of bile and helps to stabilize the functioning of the bile and liver.
Organ cleansing. This method has not been well studied. There is also no evidence as to whether stones actually dissolve when using this procedure. And those substances that can be found in the feces after cleansing are nothing more than a by-product of the cleansing procedure.

To verify the effectiveness of such methods and to detect signs of dissolution of calculi, it is necessary to do an ultrasound. Examination is advisable if it was also carried out before treatment.

How to dissolve the stones in the gallbladder and whether it is possible to remove them without surgery, only the doctor decides.

Massage

Massage has a positive effect on the activity of the organ. It not only makes him work harder, but also relaxes him well. The exercises are quite simple:

In the supine position, bend the legs, feel for the painful point under the right rib. Massage it with your thumb and forefinger in a circular motion for 5-6 seconds.
Sitting on a chair, you should lean forward and lightly press your fist on the painful point. Straighten your back. Repeat 5 times.
Lie down as in the first exercise. With your fingers, perform stroking circular movements in the area of \u200b\u200bthe right hypochondrium. Do this for 30-40 seconds.

The use of traditional medicine

A time-tested way to get rid of gallstones is to dissolve them with folk remedies. Here are some recipes:

For the purpose of cleansing, a variety of medicinal herbs and food products are used. These are strawberries, cabbage, carrots, yarrow, St. John's wort, dandelion, fennel.

They help thin bile, soften small stones that are converted into flakes and removed through the intestines.

About the need for dietary nutrition

You can prevent the formation of stones with the right approach to the use of various products. For example, a beneficial effect on the process of outflow of bile has:

content in the menu of vegetable and fruit juices;
a combination of juices with kefir, cheese;
use in the morning and evening, 5-10 g of sea buckthorn or olive oil;
green tea, which has the ability to prevent the formation of stones.

In addition, it is necessary to exclude fatty, fried, spicy foods, alcoholic beverages from the diet.. It is necessary to limit the use of sugar, spices, coffee, pickles, marinades.

Nutrition should be frequent and fractional, since every time a food bolus enters the stomach, bile flows out of the bladder. This prevents the formation of stagnant processes in it.

How to prevent thickening of bile

This process is the main culprit in stone formation. Therefore, in order to prevent it from starting, it is recommended:

an hour before bedtime, drink a glass of kefir or eat an apple;
before breakfast, it is advisable to drink a glass of water (plain or mineral without gases);
pre-meal with a small amount of vegetable salad.

These simple actions lead to the stimulation of the activity of the organ and prevent stone formation.

About exercise

It should be borne in mind that in the presence of stones in the gallbladder, you can not perform exercises related to:

weight lifting;
vibration
jumping;
sharp turns of the body;

Such exercises can provoke the movement of stones, which can lead to blockage of the bile ducts.

Therefore, the acceptable options for physical activity in cholelithiasis are:

replacing intense running with walking with acceleration;
instead of athletics exercises - stretching elements;
breathing exercises;
hiking.

If there are pronounced pain in the back, right hypochondrium, bitterness in the mouth, nausea, you should stop exercising and consult a doctor immediately.

It must be recognized that it is not always possible to remove stones without surgical intervention.

When trying to do this, there is always the danger of unwanted movement of the stone to the bile duct, which can lead to its blockage, acute attack, rupture of the bladder, peritonitis and other serious pathological processes.

The use of any method should be carried out after a thorough examination, exclusively under the supervision of a physician and subject to mandatory monitoring of changes occurring as a result of medical procedures.

All materials on the site are prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative and are not applicable without consulting the attending physician.

“Cholelithiasisthe disease is one of the most common chronic diseases in adults, ranking third after cardiovascular disease and diabetes,” – writes Doctor of Medical Sciences Ilchenko A.A., one of the leading experts on this issue in the country. The reasons for its development are a number of factors, in particular heredity, women taking oral contraceptives, obesity, eating a lot of cholesterol.

Conservative therapy can be effective only at the pre-stone stage of the disease, which at this stage is diagnosed only with the help of ultrasound. The next steps are surgical intervention. The operation for stones in the gallbladder can be reduced to the complete removal of the gallbladder, the removal of stones invasively or naturally (after crushing, dissolution).

Types of surgery, indications for carrying out

At the moment, there are several options for surgical intervention:

Cholecystectomy- removal of the gallbladder.
Cholecystolithotomy. This is a minimally invasive type of intervention that involves preserving the gallbladder and removing only deposits.
Lithotripsy. This procedure involves crushing the stones with ultrasound or laser and removing the fragments.
Contact litholysis- dissolution of stones by direct injection of certain acids into the cavity of the gallbladder.

In most cases, cholecystectomy is the removal of the gallbladder. A sufficient indication is the detection of stones and the characteristic symptoms of the disease. Mainly, it is severe pain and disturbances in the work of the gastrointestinal tract.

Important! Definitely, the operation is performed with acute cholecystitis (purulent inflammation) or choledocholithiasis (presence of stones in the bile ducts).

In the asymptomatic form, the operation may not be performed unless polyps are found in the gallbladder, its walls are calcified, or stones exceed 3 cm in diameter.

While preserving the organ, there is a high risk of recurrence - according to some reports, up to 50% of patients experience recurrent stone formation. Therefore, cholecystolithotomy is prescribed only if the removal of the organ is an unjustified risk to the patient's life.

Cholecystolithotomy and cholecystectomy can be performed through an incision or laparoscopically. In the second case, there is no violation of the tightness of the body cavity. All manipulations are carried out through punctures. This technique is used more often than the usual, open one.

Lithotripsy can be indicated for single small stones (up to 2 cm), the stable condition of the patient, the absence of complications in history. In this case, the doctor must ensure the preservation of the functions of the gallbladder, its contractility, the patency of the outflow tract of liquid secretion.

Contact litholysis is used as an alternative method when other methods are ineffective or impossible. It is developed and used mainly in the West, in Russia you can find only a few reports of a successful operation. It allows you to dissolve only stones of a cholecysteric nature. A big plus is that it can be used for any size, quantity and location.

Preparing for the operation

If the patient's condition allows, it is better to extend the time before surgery to 1 - 1.5 months. During this period, the patient is prescribed:

special diet.
Reception of funds with antisecretory activity and antispasmodics.
A course of polyenzymatic preparations.

Before the operation, the patient must pass general blood tests, urine tests, EEG, fluorography, and undergo a study for the presence of a number of infections. Mandatory is the conclusion of medical specialists who are registered with the patient.

Cavity (open) cholecystectomy

The operation is performed under general anesthesia. Its duration is 1-2 hours. A contrast agent is injected into the bile duct for better visualization. It is necessary to control the absence of stones in it. The incision is made either under the ribs or along the midline near the navel. First, the surgeon clamps with metal clips or sews up all the vessels and ducts that are connected with the gallbladder with self-absorbable threads.

The organ itself in a blunt way (to avoid cuts) is separated from the liver, adipose and connective tissue. All ligated ducts and vessels are excised, and the gallbladder is removed from the body. A drainage tube is placed in the wound to drain blood and other body fluids. This is necessary so that the doctor can monitor whether a purulent process has developed in the body cavity. With a favorable outcome, it is removed in a day.

All fabrics are sutured in layers. The patient is transferred to the intensive care unit. Until the action of anesthesia is over, you need strict control over his pulse and pressure. When he wakes up, he will have a tube in his stomach and a drip in his vein. Important! It is necessary to relax, not to try to move, to get up.

Laparoscopy

The cholecystectomy operation is also performed under general anesthesia, its duration is somewhat less than with open surgery - 30-90 minutes. The patient is placed on his back. After the onset of anesthesia, the surgeon makes several punctures in the wall of the abdominal cavity and introduces trocars there. Holes are created in different sizes. The largest one is used for visualization with a camera attached to the laparoscope and organ extraction.

Note. A trocar is a tool that can be used to gain access to the body cavity and maintain the tightness of its walls. It is a tube (tube) with a stylet (pointed rod) inserted into it.

The patient is injected with carbon dioxide into the body cavity with a needle. This is necessary to create sufficient space for surgical procedures. At least twice during the operation, the doctor will tilt the table with the patient - first, to move the organs in order to reduce the risk of damage, and then to move the intestines down.

The bubble is clamped by an automatic clamp. The duct and the organ itself are isolated using instruments inserted into one of the punctures. A catheter is inserted into the duct to prevent its compression or ejection of its contents into the abdominal cavity.

Explore the functions of the sphincter. Examine the duct to make sure that there are no stones in it. Make an incision with microscissors. The same goes for blood vessels. The bubble is carefully removed from its bed, while monitoring for damage. All of them are sealed with an electrocautery (an instrument with an electrically heated loop or tip).

After complete removal of the gallbladder, aspiration is performed. All fluids accumulated there are sucked out of the cavity - secrets of the glands, blood, etc.

With cholecystolithotomy, the organ itself is opened and stones are removed. The walls are sutured, and the damaged vessels are coagulated. Accordingly, the transection of the ducts is not carried out. Operative removal of stones without removal of the gallbladder is practiced quite rarely.

Lithotripsy

The full name of the procedure is extracorporeal shock wave lithotripsy (ESWL). It says that the operation is carried out externally, outside the body, and also that a certain type of wave is used, which destroys the stone. This is due to the fact that ultrasound has a different travel speed in different media. In soft tissues, it spreads quickly without causing any damage, and when it passes into a solid formation (stone), deformations occur that lead to cracks and destruction of the calculus.

This operation can be indicated in approximately 20% of cases with cholelithiasis. Important! It is not carried out if the patient has any other formations in the direction of the shock wave or if he must constantly take anticoagulants. They inhibit the formation of blood clots, which can complicate the healing of possible injuries, recovery after surgery.

The operation is performed under epidural anesthesia (injection of an anesthetic into the spine) or intravenous. Before the ultrasound, the doctor selects the optimal position of the patient during the ultrasound and brings the device-emitter to the selected place. The patient may feel slight jolts or even pain. It is important to remain calm and not move. Often, several approaches or sessions of lithotripsy may be needed.

The operation is considered successful if there are no stones and their parts larger than 5 mm. This happens in 90-95% of cases. After lithotripsy, the patient is prescribed a course of bile acids, which help dissolve the remaining fragments. This procedure is called oral litholysis (from the word per os - through the mouth). Its duration can be up to 12-18 months. Removal of sand and small stones from the gallbladder is carried out through the ducts.

The option of dissolving stones with a laser is possible. However, this new technique is still under development and there is little information about its implications and effectiveness. The laser as a shock wave is conducted to the stone through the puncture and is focused directly on it. Evacuation of sand occurs in a natural way.

Contact litholysis

This is an operation to remove stones with the complete safety of the organ. With the cure of the underlying disease, she has a very good prognosis. In Russia, the technique is under development, most of the operations are carried out abroad.

It includes several stages:

Imposition of a microcholecystotomy. This is a drainage tube through which the contents of the gallbladder are removed.
Assessment by injection of a contrast agent of the number and size of stones, which allows you to calculate the exact amount of litholytic (solvent) and avoid it from entering the intestines.
The introduction of methyl tert-butyl ether into the cavity of the gallbladder. This substance effectively dissolves all deposits, but can be dangerous for the mucous membranes of neighboring organs.
Evacuation through the drainage tube of bile with litholytic.
The introduction of anti-inflammatory drugs into the cavity of the gallbladder to restore the mucous membrane of its walls.

Complications

Many surgeons believe that cholecystectomy eliminates not only the consequences of the disease, but also its cause. The doctor Karl Langenbuch, who performed this operation for the first time in the 19th century, said: “It is necessary [to remove the gallbladder] not because it contains stones, but because it forms them.” However, some modern experts are sure that with an unexplained etiology, surgical intervention will not solve the problem, and the consequences of the disease will bother patients for many years.

Statistics confirm this in many respects:

The following factors increase the risk of complications:

Excess weight of the patient, his refusal to comply with the doctor's prescriptions, diet.
Errors during the operation, damage to neighboring organs.
The elderly age of the patient, the presence of a history of other diseases of the gastrointestinal tract.

The main danger of operations that do not involve the removal of the gallbladder is the recurrence of the disease, and, accordingly, all its unpleasant symptoms.

Recovery period after surgery

For several months, patients will have to follow certain recommendations, and the doctor's instructions regarding nutrition will have to be followed for life:

In the first months after surgery (even minimally invasive), physical activity should be limited. Exercises such as “bicycle”, swinging arms from a prone position are useful. Exact gymnastics can be recommended by the attending physician.
The first weeks you need to wash only in the shower, preventing the wound from getting wet. After hygiene procedures, it must be treated with an antiseptic - iodine or a weak solution of potassium permanganate.
Within 2-3 weeks, the patient must adhere to diet No. 5 (excluding fried, salty, fatty, sweet, spicy), take choleretic drugs. After the expiration of this period, it is allowed to take such products only in very limited quantities.
It is advisable to get used to eating fractionally, 5-6 times a day with breaks in the first month after the operation at 1.5-2 hours, later - 3-3.5 hours.
An annual visit to sanatoriums is recommended, especially preferably 6-7 months after the operation.

The cost of surgical intervention, the operation under the compulsory medical insurance policy

The most frequent operations described are open and laparoscopic cholecystectomy. Their price when contacting a private clinic will be approximately the same - 25,000 - 30,000 rubles in medical institutions in Moscow. Both of these varieties are included in the basic insurance program and can be carried out free of charge. The choice in favor of a public or private company lies entirely with the patient.

Lithotripsy of the gallbladder is not carried out in every medical center and only for money. The average cost is 13,000 rubles per session. Contact litholysis is not yet carried out in large quantities in Russia. Cholecystolithotomy can cost from 10,000 to 30,000 rubles. However, not all medical institutions provide such services.