Principles of Treatment

p {margin: 0; padding: 0;} .ft00{font-size:29px;font-family:Arial;color:#202020;} .ft01{font-size:17px;font-family:Arial;color:#202020;} .ft02{font-size:17px;font-family:HelveticaNeue;color:#202020;} .ft03{font-size:17px;line-height:29px;font-family:HelveticaNeue;color:#202020;} Principles of treatment Asymptomatic gallbladder lithiasis - Except in very special cases, therapeutic abstention is the rule, because the risk of complications appearing is minimal. A preventive cholecystectomy may, however, be justified in a few situations: porcelain gallbladder (significant risk of cancer), large diameter stones (> 3 cm), or congenital malformation of the bile ducts. Symptomatic or complicated gallbladder lithiasis - Its treatment almost always involves surgery (laparoscopic cholecystectomy). Drug treatment (dissolution) is based on ursodeoxycholic acid (this drug reduces the activity of HMG-CoAreductase, thereby reducing hepatic cholesterol synthesis). However, this treatment imposes several conditions (cholesterol lithiasis, treatment lasting 6 months to 2 years, gallbladder functional, radiolucent stones less than 10 mm) which are only found in less than 10% of patients. Its indication is therefore very limited. Lithiasis of the common bile duct - It must always be treated, because the complications are potentially serious. The procedure consists of endoscopic retrograde cholangiopancreatography with endoscopic biliary sphincterotomy and extraction of stones then possibly cholecystectomy. Complications of laparoscopic surgery -All types combined, they are observed in approximately 4% of cases: conversion (5%), lesions of the bile ducts (0.2 to 0.5%), mortality (less than 0.1%).