Nonsurgical management of cholelithiasis.
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.
Department of Medicine, St Vincent's Medical Center of Richmond, Staten Island, NY 10310.
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AH
Bruckstein
D000368:Aged; D002769:Cholelithiasis / Q000188:drug therapy / Q000628:therapy*; D004987:Ethers / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D012997:Solvents / Q000627:therapeutic use; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D004987:Ethers; D008738:Methyl Ethers; D012997:Solvents; C043243:methyl tert-butyl ether; D014580:Ursodeoxycholic Acid