May 1990

Nonsurgical Management of Cholelithiasis

Author Affiliations

From the Department of Medicine, St Vincent's Medical Center of Richmond, Staten Island, NY, and New York Medical College, Valhalla.

Arch Intern Med. 1990;150(5):960-964. doi:10.1001/archinte.1990.00390170022006

• Cholecystectomy is accepted and effective therapy for symptomatic cholelithiasis; until recently, it was the only therapeutic option for patients with gallstones. Recently available alternative therapy for cholelithiasis includes oral dissolution therapy with the bile salts ursodeoxycholic acid and chenodeoxycholic acid, extracorporeal shock wave lithotripsy, and instillation of methyl tert-butyl ether directly into the gallbladder. The role of each of these methods in the treatment of patients with gallstones will be reviewed, as well as the epidemiology, pathogenesis, natural history, and roentgenographic characteristics of gallstones, all of which are relevant when choosing appropriate therapy for the individual patient.

(Arch Intern Med. 1990;150:960-964)