For cholelithiasis, recent advice suggests that if you have pain for the first time, treatment can be held off until pain becomes recurrent. In cholesdocholithiasis, treatment is usually immediate. These tests can identify and remove gallstones in the common bile duct. ERCP is the procedure of choice when gallstones are large, there are multiple gallstones, there are stones in the liver, and you have jaundice. Currently, research is ongoing in this area to determine which procedure is most beneficial.
Treatment is warranted in almost all cases of common bile duct gallstones.
The best therapy will be determined by a review of medical history and the expertise of the surgeons and gastroenterologists. Physical and Metabolic Factors in Gallstone Pathogenesis . Gastrointestinal and Liver Disease. Pathophysicology, Diagnosis, Management. Nonsurgical Management of Gallstone Disease .