[Indications for the medical gallstone dissolution]

The indications for gallstone dissolution have to consider different factors of the gallbladder and its stones. The bladder must be visualized in an i.v. cholecystogram and should well contract on meal. The gallstones should not be calcified and their diameter should not be greater than 2 cm. Dissolution is only possible for cholesterol gallstones. Until today their negative presentation on x-ray is the most important hint at their composition, but pigment stones often are negative on x-ray, too. This unsatisfactory diagnosis of cholesterol gallstones in vivo restricts the success rate of gallstone dissolution to approximately 70%, when the other factors of the treatment are observed. A comparison of cost of dissolution and operation shows that despite the restricted success rate dissolution of gallstones is also justified when indications are well observed.