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How to manage gall stones?

Q: My wife has 3 mm stone in her gall bladder, detected in last month by sonogram. Her age is 38 years. 1. What is the cause of formation of stone? What precaution should be taken to avoid it increasing further? 2. Is there way out to dissolve the stone with medicine without any operation? Please recommend suitable medicine. Is there any danger associated with such medicine? 3. In case it is essential to go for operation, then whether normal operation is better or laparoscopy operation? 4. By operation, it is said that the gallbladder itself will be removed. How the function of gall bladder will happen without it? What problems will it give due to removal of gall bladder? 5. Is there any guarantee that same problem will not recur after gall bladder removal? 6. Is it possible that only stone be removed by operation and not entire gall bladder? This is most important question. Which is better? 7. How much will it cost for operation? What type of surgeon should be contacted for operation? 8. Please advise on any precautions to be taken.

A:1. Stones in GB are quite common. There is a genetic predisposition, sometimes diet rich in fats, but mainly we do not know the exact cause in a particular individual. Sometimes it happens soon after pregnancy and sometimes in those who use pills. Stones cause pain which is usually precipitated by a diet rich in fat. 2. A 3 mm stones can be dissolved by use of udiliv, 1 tab three times a day for 3 months. Diarrhoea may be a troublesome side effect but is very uncommon 3. Gall bladder should only be removed laparoscopically. 4. Occasional patient may have increased frequency of motion but the storage function of gall bladder is taken over by the bile duct which dilates a little bit after the GB is removed. 5. Most patients are cured after surgery but in some patients stones may form in the bile duct in the 1-2 years. They can also be removed endoscopically if it were to happen. 6. Stones alone should not be removed as it is the diseased gall bladder where the stones form. 7. Most general surgeons with experience in laparoscopy can remove the gallbladder. 8. The cost of the operation in a good centre will be approx Rs. 25-30,000/- 9. Avoid heavy fatty meals as long you have the stones. With the first attack of pain you should have it removed.

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