A significant proportion of patients who are referred with gallstone disease will request treatment that does not involve removal of the gallbladder.
In elderly frail patients with many co-morbid conditions and in whom a general anaesthetic has a high risk, a long term low fat diet is an option. However, even this does not guarantee complete avoidance of symptoms or complications of gall stones.
This was popularised in the 1980's for patients with pure cholesterol stones. This required long term treatment with bile acids and when the treatment was stopped the stones recurred. Consequently this treatment has fallen into disrepute.
Unlike kidney stones where this is an appropriate treatment, for most patients with gallstones this is not useful. Firstly gallstones are largely radio-luscent and cannot therefore be localised for the lithotripter. Secondly the consequence of shattering stones in the gallbladder would be to release fragments of stone into the common bile duct with a possible secondary development of acute pancreatitis. This is an extremely serious condition with a mortality of 5-10% and is to be avoided at all costs.