Is surgery the only option if I have gallstones that are causing pain?

It is perhaps more accurate to say that surgery is currently the recommended option for symptomatic gallstone disease especially if the surgical risk is deemed to be low or minimal. This option is also believed to be the most definitive treatment so far.

In the event when the surgical risk is high (e.g. elderly with multiple medical problems including heart diseases or stroke) or when a person is not keen for surgery, symptomatic treatment plus attempting gallstone dissolution with oral therapy may be an alternative option. Depending on the type, number and size of stones present, the response to such dissolution treatment remained highly variable.

One point to note is the need to remain on such treatment on a long term basis to prevent stone reformation even if proven effective. As such, oral stone dissolution therapy is usually chosen only when surgery is excluded as an option for any reason.

- Dr Quan

Surgery is the mainstay of treatment for gallstones that are causing pain. There are other options for treatment of gallstones which include dissolution therapy, shock wave therapy and even endoscopic approach. However, the failure rates are higher and most of these therapies are prone to recurrence and other complications. As such, such therapies are restricted to certain categories of patients.

In balancing the pros and cons, in an experienced centre with good surgical and anesthetic support, it is safer and more efficient to treat symptomatic gallstones with a simple surgery. In my experience, when the gallstones have not evolved to a complicated situation, the surgery can be done safely through a 'scarless' technique which can be completed within half an hour with minimal post surgery pain.

Symptomatic gallstone is an indication for surgery. There have been attempts in the past to blast the stones with shock wave therapy and also melt the stones using special enzymes, but the recurrence rate was very high.

Enzyme therapy is also very expensive and in the long term will cost more than surgery.

Laparoscopic gallstone surgery is safe in trained hands and can even be done as a day procedure. Talk to your surgeon about it.