Further management of gallstones
ERCP demonstrates stones in the duct with greater accuracy than ultrasound, particularly at the lower end of the CBD, which may be obscured by duodenal gas and also allows for sphincterotomy and stone removal. Laparoscopic cholecystectomy is the preferred method of treatment for symptomatic gallbladder disease in an elective setting and has well-recognized benefits over open surgery in experiencedGallstone Ileus
hands. Acute cholecystitis is also increasingly managed by early laparoscopic surgery, with a slightly higher rate of conversion to open surgery than elective cases.3 Laparoscopic ultrasound may be used as a suitable alternative to operative cholangiography to examine the common duct for residual stones during surgery.4 Both ultrasound and cholescintigraphy are used in monitoring postoperative biliary leaks or haematoma (Fig. below).
Postoperative bile collection in the gallbladder bed and Hyperechoic, irregular mass in the gallbladder bed which represents a resolving haematoma after laparoscopic cholecystectomy.
Other, less common options include dissolution therapy and extracorporeal shock wave lithotripsy (ESWL). However, these treatments are often only partially successful, require careful patient selection and also run a significant risk of stone recurrence.
ultrasound images ERCP, ultrasound images ERCP less common options include dissolution, ultrasound images laparoscopic surgery, ultrasound images cholecystectomy.
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