Ursodiol is a natural occuring bile salt or bile acid. You may have heard of Actigall. Actigall is one brand name for ursodiol. Although ursodiol has been FDA approved for dissolving cholesterol gallstones and for the prevention of gallstones, since the introduction of the laparoscopy gallbladder removal is the medical treatment of choice for gallstones. Surgery is quick; dissolving gallstones with ursodiol or other bile salts takes a long time. And whether done via lithotripsy or bile acids, research shows that 50% of the time the stones will come back.5 The same will be true for liver and gallbladder flushes too unless dietary changes are made and fat digestion is improved.
Gallstones may be removed from the gallbladder by means of a gallbladder and liver flush. However, this is helpful with small stones and very difficult with large ones. The importance of dietary changes cannot be stressed enough and improving fat metabolism as well. Gallstones should be treated only if they cause symptoms. For recurrent gallbladder attacks, the most effective treatment is surgical removal of the gallbladder, or cholecystectomy. The traditional procedure is a major surgery requiring a five-inch incision and a hospital stay of up to a week.
Fortunately, it has been largely replaced by laparoscopic cholecystectomy, in which the surgeon removes the gallbladder with instruments inserted through small incisions in the skin, below the liver. This procedure requires only an overnight hospital stay and a week of recovery at home.
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Cholecystectomy means the surgical removal of the gallbladder. This is usually performed with keyhole surgery (minimally invasive surgery) - a small incision is made. However, sometimes keyhole surgery is not possible for about 10% of patients, who need open cholecystectomy. With open cholecystectomy a large cut is made in the patient's abdomen. Patients who undergo open surgery require a longer hospital stay and recovery time. If a patient's gallbladder is severely inflamed he/she will require open surgery. A study found that using a robotic assistant to remove a patient's gallbladder by key-hole surgery (laparoscopic cholecystectomy) is as safe as working with a human assistant. The gallbladder can be removed by entering through the vagina. A study found that contrary to widespread belief, early cholecystectomy significantly reduces hospital stays in patients with mild to moderate gallstone pancreatitis with no increase in complications or mortality.
As approximately 1 in 4 patients who undergo cholecystectomy have gallstone recurrence within a year, many patients are given urosdeoxycholic acid (the acid found in bile). Urosdeoxycholic acid lowers the cholesterol content of bile, making it less likely that stones will form.
Lithotripsy - Ultrasonic shock waves are aimed at the gallstones which break them up. If they become small enough they can then pass safely in the patients stools. This type of treatment is uncommon and is only ever used when there are few gallstones present.