There are three major types of gallstones classified as pure, mixed and combined depending on the composition of the three essential components which are calcium carbonate, bile pigment, and cholesterol. Firstly, the pure class has another set of categories designated as purely cholesterol, pigment or calcium carbonate stones. The pure cholesterol stones are large, oval and mostly radiolucent. Some stones deposit in the macrophages found in the mucosa of the gallbladder resulting in high cholesterol levels. Secondly, mixed gallstones are the most prevalent of the three broad categories, with a prevalence of 80% of all the cases of gallstones. They contain cholesterol monohydrate in a greater proportion with many multifaceted crystals. Thirdly, the combined group is characterized by big and smooth stones. Its nucleus is of pure gallstones while its shell is of mixed composition (Mohan, 2014).
The treatment for gallstones varies regarding approach depending on the stage of the patient. Once the gallstones become symptomatic and those who present with complications, there is a greater tendency to consider cholecystectomy and cholecystostomy. A patient who has pain due to the stones finds pain management services at the emergency section of a hospital then finer care once admitted to the ward for follow-up and a better determination of the appropriate treatment for the underlying cause of pain (Heuman, 2014).
Medical treatment of gallstones in a patient with a healthy gall bladder yields better results when bile salt therapy using ursodeoxycholic acid is applied. Moreover, higher success rates are in patients with small gallstones of less than 1cm diameter with a high content of cholesterol. In laparoscopic cholecystectomy, follow-up for up to a year is a recommendation for patients with gallstones in the peritoneal cavity (Heuman, 2014).
References
Heuman, D. (2014). Gallstones (Cholelithiasis) Treatment & Management: Approach Considerations, Treatment of Asymptomatic Gallstones, Treatment of Patients with Symptomatic Gallstones. Emedicine.medscape.com. Retrieved 18 January 2017, from http://emedicine.medscape.com/article/175667-treatment#d1
Mohan, H. (2014). Textbook of Pathology (7th ed.). New Delhi: Jaypee Bros.
