To remove or not to remove my gallbladder

[cscarlson]

I have two related questions that will help me make the decision as to whether or not to have my gallbladder removed.

Question 1

I've read somewhere that there is a correlation between statin drugs and the formation of gallstones. The little information I've read seems to be equivocal. I need to know the predominant medical information as to such a correlation. Does the use of statin drugs increase or decrease the probability of gallstones? The reason is that I am being advised to have my gallbladder removed, unless I can find out why the one 4 mm gallstone that I have has formed. If I can find out why this gallstone has formed, they may want to break it up. If I don't discover why the stone is formed, then any break up will be followed by more stones, and surgery is the better way to proceed. I take the statin Zocor daily, along with a low fat diet, thus the question.

Question 2

I have been diagnosed with Cholelithiasis (gallstones). I have one 4 mm gallstone. I have had two episodes over the last 5 months of severe pain (lasting approx 8 hours, located between center of stomach and abdomen, some vomiting). I have no other symptoms and am in very good health (feel good, low fat diet, regular exercise). My dilemma is whether or not to follow doctor advice to have my gallbladder removed. The alternative would be to try to break up the one gallstone. This would only be a possibility if I understand and correct the reason for the formation of the one gallstone, otherwise the cycle repeats and I should have the gallbladder removed. Since I want to explore all reasonable options before surgery, my second question is IF there is a reasonable probability that my one gallstone is formed as a result of a positive correlation from statin use, then is it a good idea, based on above data, to try to break up the gallstone with Extracorporeal Shock Wave Lithotripsy (ESWL) or use of the drug Ursodiol (Actigall). The reason I am considering this possibility is that if the answer to question 1 is that the statin is probably forming my gallstone, then I will research non statin drugs to manage my cholesterol and consider the ESWL or Ursodil. If ESWL and/or Ursodiol are not good ideas regardless of the cause of gallstone formation, then I’m off to surgery.

Thank you.

[Kevin Pho, MD]

To answer your questions:
1) Although possible, I am not aware of statins leading the gallstones.  I was not able to find a connection in the PDR as well.

2) The decision whether to pursue surgery or not depends on the medical risk as well as the characteristics of the stone itself (i.e. stone buoyency, presence of calcification etc.).  CT scan of the gallbladder can be considered to further define the stones.  

If there is concern about the proper treatment, I would advise obtaining another GI or surgical opinion.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[celine149]

Did your Dr. ask you to try and find out the reason why your body formed a gallstone? If so, I have never heard of anything like that in my life. After all, he is the Dr. not you. If he doesn't know, how are you supposed to research it and find out. I doubt anyone can tell you the exact reason why you formed one.

[cscarlson]

No, my doctor did not ask me to research the correlation between statin drugs and Gallstones. This is my attempt to consider all alternatives before surgery. Sorry if my post did not make this clear. My doctor recommends surgery, but will support alternative treatment if I so choose. I need to get answers to the two questions that I posted. Hopefully, someone can help with the answers.

[jono]

One reason for them forming is bile sitting in the gallbladder it then crystallises to form gallstones. One way of getting them is to go on a crash diet where you reduce your fat intake dramatically so your body does not need to use as much bile.

A lot of people have them and they remain silent causeing no problems but if they are cuasing symptoms then the docs usually take the approach of taking out the gallbladder as if you have them  then you will get them again if they just remove the stone.

I had the operation (keyhole) I was nervous going in for it but it really was not that bad. I was up and walking around (not too fast) that night.

Take care

J

[conniebear]

I also wanted to make a comment regarding the size of the gallstone....even the littlest gallstone can cause severe pain and vomiting....so breaking up the larger one will not accomplish anything. Removing the gallbladder is a very common procedure so I would not be too worried about it....keeping a diseased gallbladder can cause pancreatitis and you don't want that!  Once you have that then you will have chronic pain for the rest of your life.

[stiman]

I would op to take it out, further complications of these stones can develop, stone getting stuck in the bile duct causes jaundice and haveing then an ERCP, which has lots of complications also!

A stone can get stuck near the pancreatic duct causing acute pancreatitis, which believe me is no fun.

This is not to scare you, but if its causing symtoms, i would get it taken out.

[meetnishant]

A related discussion, Cure for gall bladder was started.