What are the indications and contraindications for surgery in patients with gallstones? Let's find out!
(1) Surgical treatment for hepatobiliary stones
Indications: Surgery should be chosen for patients who are not suitable for non-surgical treatment or whose non-surgical treatment has unclear effects, or even for those whose stones increase in size and number and symptoms worsen. Surgery should be performed promptly for patients with severe obstruction and complications caused by stones, such as acute cholangitis.
Surgical procedures include: cholecystotomy, choledochotomy, cholecystectomy, hepatic lobectomy, choledochoduodenostomy, external biliary drainage, percutaneous transhepatic cholangiography or cholecystolithotomy, endoscopic sphincterotomy, etc.
Contraindications: Patients with myocardial infarction, heart failure, poor pulmonary, liver, or kidney function, coagulation disorders, advanced age, malnutrition, extreme weakness, etc.
(2) Surgical treatment for renal stones
Indications: Surgical stone removal is only necessary for a small number of patients with renal stones. The indications for surgery can be summarized as follows: stones larger than 1cm and located at the renal or ureteral narrowings (congenital malformation), multiple stones in the renal pelvis with significant symptoms, large isolated kidney stones, stones causing acute obstructive oliguria or anuria, severe kidney damage after infection, failure of extracorporeal lithotripsy, or patients for whom various non-surgical treatments have been ineffective.
Surgical procedures include: pyelolithotomy or calyceal incision and stone removal, renal incision and stone removal, partial nephrectomy, nephrectomy, special types of renal stone management, percutaneous nephrolithotomy, etc.
Contraindications: Same as for gallstone disease.
