الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
There are many alternatives to surgical cholecystectomy in management of gallstones. Among these is the oral bile salt therapy for cholesterol gallbladder stones, less than 15 mm in diameter in the presence of functioning gallbladder on oral cholecystogram to ensure patency of cystic duct . Endoscopic sphincterotomy is now established as the treatment of choice in most cases of retained or recurrent stones in the common bile duct after cholecystectomy since reoperation carries significant morbidity. However, the indications of endoscopic sphincterotomy have been extended now to include patients who have not undergone biliary surgery and elective cholecystectomy whenever possible should be advocated because of the high incidence of acute cholecystitis in patients with gallbladder stones or non visualized gallbladders. Lithotripsy (extracorporeal shock wave, laser or ultrasonic) has been shown to effectively fragment gall stones in fragments measuring less than 2 mm that usually pass spontaneously to the duodenum otherwise it can be extracted by endoscopy. Laparoscopy can be utilized to remove the gallbladder with either electrocautry or laser.