Therapeutic options for gallstones

Patients with asymptomatic gallstones should not be considered surgical candidates; patients with defined symptoms of biliary tract disease, however, should be advised not to postpone surgery or endoscopic sphincterotomy with stone retrieval. A smaller group of patients who fulfill specific criteria may benefit from chenodiol (Chenix) therapy and long-term follow-up. Such experimental techniques as dissolution with methyl tert-butyl ether and fragmentation with extracorporeal shock waves hold exciting promise for the future.