The development of human gallbladder stones shown in X-ray pictures and its importance for the therapy.

Prophylactic treatment of patients with gallbladder stones today is obsolete. After secured diagnosis the patients and their physicians are waiting for the development of painful symptoms, mostly for years. Follow-up studies of gallbladder stones over decades show that there is no stability: especially the cholesterol stones change their size, shape, composition, and number during the waiting period for surgery. With a litholytical treatment of the cholesterol stones one has the chance to interrupt such changing processes by dissolution, with or without perfectionism. One can stop the development of painful symptoms and reduce the burden of the stones. To prevent an improper use of this treatment, only young, correctly floating cholesterol stones and the 2nd generation of cholesterol stones should be treated prophylactically. The diagnosis of the floating stones is possible with ultrasound or X-rays. We show the dissolution of the 2nd generation of cholesterol stones in two polymorbid, old patients with high risk for surgical treatment. The changing of the composition of gallbladder stones is demonstrated by different surface calcifications of multiple and solitary cholesterol stones, flat for multiple and periodically ordered for solitary stones.