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ERCP Endoscopic Retrograde Cholangiopancreatography

If your gallstones don’t cause any symptoms, you often don’t need treatment.

Gallstones that do cause symptoms should be treated right away. They may lead to damage or infection if your bile ducts are blocked for a long time.

If your symptoms don’t go away, your treatment may include:

  • ERCP (endoscopic retrograde cholangiopancreatography). ERCP uses both X-ray and a long flexible lighted tube (endoscope). The tube is put into your mouth and throat. It goes down your food pipe (esophagus), through your stomach, and into the first part of your small intestine (duodenum). A dye is put into your bile ducts through the tube. The dye lets the bile ducts be seen clearly on X-rays. Small stones can be taken out through the scope.
  • Sphincterotomy. This can also be done through the tube during an ERCP. Tight rings of muscle (called sphincters) are around the openings of the bile ducts. They can block gallstones. Cutting these rings lets the ducts open wider so that stones can pass into your intestine.
  • Gallbladder removal (cholecystectomy). If stones are in your gallbladder, your gallbladder must be removed. These stones cannot be taken out with ERCP. Gallbladder removal is a common surgery. Your body will work well without your gallbladder. It is not essential for a healthy life.
  • Percutaneous drainage/cholecystostomy. If stones in your gallbladder cause a blockage of bile acid and  subsequent infection, your gallbladder will have to be removed. However, if you are too sick to undergo surgery or there are other complications, a drainage tube may be inserted into  your gallbladder through the skin of your abdomen. This will temporarily remove the blockage and drain any infection.
  • Oral dissolution therapy. The stones are dissolved using medicines made from bile acid.
  • Methyl-tert-butyl ether. This solution can be shot (injected) into your gallbladder to dissolve stones. This is an experimental procedure.

Most people respond very well once their stones are dissolved or taken out.