Nonsurgical management of gallstone disease

Cholelithiasis is a common disease in the US associated with significant mo rbidity. Surgical treatment with cholecystectomy has been increasing with a significant cost to the health care system and is not without risk. Cholec ystectomies are often performed unnecessarily in gallstone patients with no nspecific symptoms. Although cholecystectomy is the mainstay of gallstone t reatment, nonsurgical treatment alternatives, such as bile acid therapy, to pical dissolution, and extracorporeal shock-wave lithotripsy (if available) may be used in selected patients. Ln some cases, in particular in the elde rly and in other patients at increased risk from surgery, nonsurgical manag ement offers lower morbidity and mortality than does operative treatment.