Generally speaking, patients with gallstones can prevent acute attack by adjusting diet and improving lifestyle. Spasmodic and analgesic drugs: Non-steroidal anti-inflammatory drugs (NSAID) such as diclofenac, ketoprofen or indomethacin have analgesic effects on biliary colic. Anisodamine is usually used as an antispasmodic drug. Cholestasis and anti-infection treatment: you can take dehydrocholic acid tablets or ursodeoxycholic acid tablets to promote bile elimination and control inflammation. However, these two drugs are not suitable for biliary obstruction. For patients with mild acute cholecystitis, amoxicillin and clavulanic acid combined with metronidazole can be used for anti-infection treatment. For complex cholecystitis, such as acute cholangitis with severe infection, broad-spectrum antibiotics are usually needed. Surgical treatment of symptomatic cholelithiasis patients should be treated as soon as possible, because about 50% patients will have recurrence of biliary colic, and patients with recurrent cholelithiasis are more likely to cause complications such as biliary pancreatitis, obstructive jaundice and cholangitis.
Patients with symptomatic gallstones should receive surgical treatment as soon as possible, and minimally invasive laparoscopic cholecystectomy is the first choice. For patients with bile duct stones, endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy or laparoscopic bile duct exploration combined with cholecystectomy are the first choice. When stones cannot be completely removed during operation, T tube drainage can be retained, biliary obstruction can be relieved first, and then radical resection can be performed.
Treatment of gallstones with classic prescriptions of traditional Chinese medicine: Chinese medicine often uses classic prescriptions such as Dachaihu Decoction and Yinchenhao Decoction in clinic, which has certain curative effect, but lacks evidence-based medical evidence. Chinese patent medicine: There are many kinds of Chinese patent medicines for treating cholelithiasis, which can relieve the clinical symptoms of cholelithiasis, improve the contraction function of gallbladder and prevent the formation of stones. Others: including acupuncture, auricular point, moxibustion, massage and other treatment methods. Acupuncture and auricular point therapy are the most common in clinic and have certain curative effect on some patients.
Other treatment methods, percutaneous transhepatic biliary drainage (PTD), are feasible for patients with severe intrahepatic biliary obstruction complicated with inflammation, which can drain biliary tract, control infection, reduce mortality and win operation time. Endoscopic duodenal papillotomy (EST) This method is suitable for lower bile duct stones, especially for patients with stenosis of common bile duct outlet. This treatment method can simultaneously remove stones at the lower end of bile duct.