[Cholelithiasis--non-surgical intervention. Definitive and combined use]

Area of Science:

• Gastroenterology and Hepatology
• Minimally Invasive Surgery
• Interventional Radiology

Context:

• Advancements in endoscopic and radiological techniques, alongside pharmacological developments, have expanded non-operative treatment options for gallstone diseases.
• These innovations are driven by the need for less invasive alternatives, particularly for high-surgical risk patients and those with post-cholecystectomy bile duct stones.

Purpose:

• To review the evolving landscape of non-operative therapeutic modalities for gallstone diseases.
• To highlight the role of endoscopic, radiological, and pharmacological approaches in managing gallstones.
• To compare the efficacy and indications of these new methods against the established standard of cholecystectomy.

Summary:

• Non-operative treatments for gallstone disease now include endoscopic and radiological procedures for biliary and gallbladder stones.
• Extracorporeal lithotripsy and chemical litholysis are increasingly utilized for gallbladder stones.
• Laparoscopic cholecystectomy represents a novel surgical option, with various approaches assessed against the benchmark of traditional cholecystectomy.

Impact:

• Provides a comprehensive overview of current non-operative gallstone treatments.
• Facilitates informed clinical decision-making by comparing diverse therapeutic modalities.
• Establishes a benchmark for evaluating new gallstone interventions relative to established surgical standards.