Initial treatment of gallstones in the biliary tree may involves stabilizing the patient if infection is present. This entails IV fluids, analgesia and antibiotics.
The removal of a stone is best achieved via ERCP, sphincterotomy and extraction with Dormia basket or balloon. ERCP is only successful in about 90% of patients. Large stones are difficult to remove. These patients need surgical exploration of the bile ducts, removal of the stones and closure of the duct over a T-tube. Usually, the T-tube is removed ten days later following a T-tube cholangiogram.
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