How to treat gallstones with sand-like particles?

Generally, treatment methods for sand-like gallstones include conservative management, medication, extracorporeal shock wave lithotripsy (ESWL), endoscopic stone removal, and surgical intervention. The specific treatment plan should be determined based on the number of stones, symptoms, and the patient's overall health condition. It is recommended to seek timely medical evaluation. Detailed analysis is as follows:

1. Conservative Management

Patients should adjust their diet by reducing intake of high-fat and high-cholesterol foods such as organ meats and fried foods, to avoid stimulating gallbladder contraction and causing discomfort. Eating regular meals at consistent times helps prevent prolonged fasting, which can lead to bile stasis and worsen stone formation. Regular moderate exercise and weight control are also important to reduce the impact of obesity on gallbladder function and help slow the progression of gallstone disease.

2. Medication

For patients with no symptoms or mild symptoms, doctors may prescribe bile-promoting and stone-expelling medications such as ursodeoxycholic acid capsules, anti-inflammatory and cholagogue tablets, or Lysimachiae herba granules. Ursodeoxycholic acid helps regulate bile composition and promotes the dissolution of cholesterol stones. Anti-inflammatory and cholagogue tablets and Lysimachiae herba granules have effects of clearing heat, eliminating dampness, soothing the liver, and promoting bile flow, which can help alleviate gallbladder inflammation and assist in expelling small, sand-like stones.

3. Extracorporeal Shock Wave Lithotripsy (ESWL)

This method is suitable for patients with relatively small and few gallstones and normal gallbladder function. ESWL uses externally generated shock waves focused on the stones to break the sand-like stones into even smaller particles, facilitating their excretion through bile. This non-invasive procedure causes minimal trauma to the body.

4. Endoscopic Stone Removal

If sand-like stones block the bile duct and cause symptoms, endoscopic stone removal may be performed. The doctor inserts an endoscope through the mouth into the bile duct and uses specialized instruments to remove the stones, or places a biliary stent to drain bile and relieve obstruction. This minimally invasive approach allows for rapid recovery and is suitable for patients who cannot tolerate surgery or have stones in difficult-to-reach locations.

5. Surgical Treatment

Surgery is recommended for patients experiencing recurrent biliary colic or cholecystitis, or those with numerous stones or complications such as gallbladder atrophy. The most common procedure is laparoscopic cholecystectomy. Removing the diseased gallbladder eliminates the source of stones and prevents complications such as cholangitis and pancreatitis caused by recurrent stone irritation. It is an effective treatment for symptomatic sand-like gallstones.

During treatment, patients should undergo regular abdominal ultrasound follow-ups to monitor changes in the stones. Immediate medical attention is required if symptoms such as worsening abdominal pain, fever, or jaundice occur. A light, balanced diet should be maintained, avoiding overeating. Patients must adhere to prescribed treatments and should not adjust medication doses or attempt unproven remedies on their own, to prevent delays in proper care.