From the Research
A gallstone lodged in the gallbladder neck typically requires surgical intervention through laparoscopic cholecystectomy (gallbladder removal) as the most effective treatment option. This approach is supported by the most recent and highest quality study available, which compared different treatment strategies for gallstones and common bile duct stones 1. While waiting for surgery, pain management with NSAIDs like ibuprofen (400-600mg every 6 hours) or prescription medications such as hydrocodone/acetaminophen may be necessary.
Key Considerations
- Antibiotics (often ceftriaxone 1-2g IV daily plus metronidazole 500mg IV every 8 hours) are indicated if infection is present, shown by fever, elevated white blood cell count, or severe pain 1.
- Patients should follow a low-fat diet and stay well-hydrated until surgery.
- In rare cases where surgery isn't possible, endoscopic retrograde cholangiopancreatography (ERCP) might be used to remove stones, or medications like ursodeoxycholic acid could dissolve smaller stones over months.
- Prompt intervention is important because a lodged gallstone can lead to serious complications including acute cholecystitis, pancreatitis, or biliary obstruction.
Treatment Options
- Laparoscopic cholecystectomy is the gold standard of treatment for acute cholecystitis, offering a safe and effective approach with minimal invasiveness 1.
- Therapeutic endoscopy, including transpapillary and transmural stenting, is an emerging alternative for patients with prohibitive operative risk.
- Percutaneous cholecystostomy tube (PCT) placement is an option when patient-specific factors prevent both surgical and endoscopic treatment, though it is associated with worse outcomes compared to other treatment options 1.
Conclusion Not Applicable - Direct Answer Only
Laparoscopic cholecystectomy remains the preferred treatment for a gallstone lodged in the gallbladder neck, due to its effectiveness in preventing complications and improving patient outcomes 1.