Medical Approach

Medical treatment, apart from analgesia, should not be initiated in the ED.

For selected patients with high surgical risk, medical therapies may rarely be considered. Oral bile salt therapy (ursodeoxycholic acid, chenodeoxycholic acid) is not useful once gall stones have developed, but can prevent their development in high risk groups [14].

Extracorporeal shockwave lithotripsy has usually been used together with sphincterotomy and a percutaneous approach. It has a high failure rate (95%) when used alone, and a high complication rate (19%).