Gallbladder-preserving gallstone treatment removes the stones but keeps the gallbladder in place. Many patients in the UAE hear that surgery to remove the gallbladder (cholecystectomy) is their only option. However, this approach offers a different route to relief from gallstone pain. GO-SCOPE is one such procedure, and Dr. John Smirniotopoulos performs it in Washington, D.C., United States.
This guide explains how the procedure works, what the published studies report, who may be suitable, and how patients travelling from the UAE plan their treatment. We wrote it for patients rather than doctors, and we link every figure to its source.
Hearing that you need surgery can feel final. As a result, many patients ask the same questions: Can I keep my gallbladder? Will the stones come back? How long would I need to stay abroad? The sections below answer each one directly.
What is GO-SCOPE gallbladder-preserving gallstone treatment?
GO-SCOPE stands for Gallstone Organ-Sparing Cholangioscopy and Percutaneous Extraction. This minimally invasive procedure removes gallstones through a small opening in the skin, using imaging and a camera scope, while the gallbladder stays in the body. Dr. John Smirniotopoulos performs it in Washington, D.C.; however, it is not available in the UAE.
Conventional treatment removes the whole gallbladder, usually by keyhole (laparoscopic) surgery. In contrast, GO-SCOPE treats the stones and keeps the organ that stores and releases bile.
How the procedure works, step by step
In the published GO-SCOPE studies, the procedure followed these main steps:
- Access. First, the doctor uses image guidance to create a small passage through the skin into the gallbladder (percutaneous access).
- Visualisation. Next, the doctor passes a thin scope with a camera (cholangioscopy) into the gallbladder to see the stones directly.
- Fragmentation. Then the doctor breaks larger stones into small pieces with lithotripsy, for example laser, electrohydraulic or dual-energy devices.
- Removal. After that, the team takes out the fragments with a small basket and by flushing (irrigation).
- Drainage tube. Finally, the doctor leaves a small tube in place so the gallbladder can drain while the access track heals. The team takes it out at a later visit.
During the procedure, the team uses conscious sedation or light anaesthesia. Overall, the average procedure in the largest published GO-SCOPE series took 54 minutes.
Key terms explained
| Term | What it means |
|---|---|
| Cholecystectomy | Surgery that takes out the gallbladder |
| Percutaneous | Through a small opening in the skin |
| Cholangioscopy | A look inside with a thin camera scope |
| Lithotripsy | A method that breaks stones into smaller pieces |
| Cholecystostomy tube | A small drainage tube that sits in the gallbladder |
| Biliary colic | Gallstone pain, especially after meals |
What do the published results show?
In a published series of 51 patients with gallstone pain, the team removed all visible stones in every procedure (100% technical success), with no major adverse events. Patients also stayed in hospital for an average of 23 hours. Furthermore, all patients were free of pain at follow-up when the team took out the drainage tube.
Three GO-SCOPE research abstracts appear on goscope.ae, and our Clinical Evidence page summarises them. Their main findings are below.
| Study | Patients | Stones removed | Major complications | Hospital stay | Drainage tube removed after |
|---|---|---|---|---|---|
| Abstract No. 99: same-day outpatient GO-SCOPE | 51 | 100% | None reported | Average 23 hours | Average 21.8 days |
| Abstract No. 326: outcomes in patients preserving the gallbladder | 51 | 100% | None by SIR criteria; 1 sepsis, 1 later cholecystectomy | Not stated | Average 21.8 days |
| Multi-institutional study: patients unable to have surgery | 12 | 100% in one session | None reported | Median 1 day | Average 35 days |
In addition, these studies reported the following:
- Symptom relief. Patients reported complete or near-complete relief from gallstone pain. Moreover, over a median follow-up of 208 days, no patient developed acute inflammation of the gallbladder (cholecystitis) or bile ducts (cholangitis).
- Residual stones. One of 51 patients (2.0%) still had a small 4 mm stone on imaging three months later.
- Older, high-risk patients. Similarly, the multi-institutional study treated 12 patients aged 52 to 94 who could not have surgery. Their stones measured 1.2 to 4.0 cm.
- Complications are possible. For example, one patient in Abstract No. 326 developed sepsis 17 days after the procedure. Another chose gallbladder removal after bile leaked when the drainage tube came out early.
What the evidence cannot yet tell you
These are small, retrospective studies from a limited number of centres. Also, Abstracts No. 99 and No. 326 appear to describe the same 51-patient group, so readers should not add them together. In addition, long-term data on whether stones come back over many years is still limited. Therefore, ask your doctor how these results apply to you, and browse all GO-SCOPE research.
Who may be suitable for gallbladder-preserving treatment?
Gallbladder-preserving treatment may suit adults with symptomatic gallstones on imaging whose doctors have advised gallbladder removal, especially when they want to keep the organ. It may also suit some high-risk patients who cannot safely have surgery. However, a specialist decides suitability only after reviewing your scans and medical history.
You may be a candidate when you:
- Have gallstones that show on ultrasound, CT or MRI
- Have pain in the upper right abdomen, especially after meals
- Feel nausea or vomit after eating, or have pain that spreads to the right shoulder or back
- Prefer to keep your gallbladder, even though a doctor advised removal
- Face a high risk from surgery because of age or other health conditions
- Can travel to Washington, D.C. for treatment and follow-up
Still, GO-SCOPE is not right for everyone. Your specialist will explain when conventional surgery is the better choice for you. Meanwhile, use the checklist on Is GO-SCOPE For Me? to prepare for that conversation.
How GO-SCOPE compares with other options
| Gallbladder removal (laparoscopic cholecystectomy) | GO-SCOPE (gallbladder-preserving) | Watchful waiting | |
|---|---|---|---|
| What happens | A surgeon takes out the gallbladder and its stones | The doctor takes out the stones, while the gallbladder stays | No procedure; your doctor monitors symptoms |
| Gallbladder after treatment | Gone | Preserved | Preserved |
| Can new stones form? | Not in the gallbladder, because it is gone | Yes, because the gallbladder remains | The existing stones remain |
| Where available | Widely, including in the UAE | Only in Washington, D.C. | Any doctor |
| Typical hospital stay | Often the same day or overnight (general information; confirm with your surgeon) | Average 23 hours in the published series | None |
| Extra step to plan for | Surgical recovery | Drainage tube for about 3 weeks | Risk of further attacks |
According to the NIDDK, laparoscopic cholecystectomy remains the standard treatment for symptomatic gallstones. Therefore, treat gallbladder preservation as an option to discuss with a specialist rather than a replacement for medical advice.
How do UAE patients plan treatment in Washington, D.C.?
UAE patients start with a consultation, during which the team reviews their scans and medical history. If the procedure suits them, they then travel to Washington, D.C. Most patients go home from hospital within about a day. However, the drainage tube usually stays in place for around three weeks until the team takes it out.
Dr. John Smirniotopoulos performs GO-SCOPE only in Washington, D.C. Consequently, patients cannot have it in the UAE or any other country.
Step 1: Prepare your medical records
Before your consultation, gather recent reports and images that show your gallstones:
- Your abdominal ultrasound report and images
- CT or MRI (including MRCP) scans, if you have them
- Recent blood test results and a list of current medications
- Notes from any doctor who advised gallbladder removal
Step 2: Book a consultation
During the consultation, the team reviews your records and tells you whether GO-SCOPE may suit you. Also ask whether the team can do this first review remotely, before you travel.
Step 3: Plan your stay
Most of the planning centres on the drainage tube. In the main published series, the team took out the tube after an average of 21.8 days. So ask the team whether you should stay in the United States until then, or how they arrange removal and follow-up.
In particular, plan for:
- Flights, visas and accommodation for you and any companion
- Pre-procedure checks, the procedure itself and the first recovery days
- The drainage tube period and its removal
- Travel insurance that covers medical treatment abroad
Step 4: Follow-up after you return home
After the procedure, follow-up visits confirm that the stones have gone and check how your gallbladder works. Your doctor in the UAE may also share some of this care. Therefore, keep copies of all procedure reports and images for them.
Questions to ask at your consultation
- Am I a suitable candidate, given the size and number of my stones?
- How does GO-SCOPE compare with gallbladder removal in my case?
- How long should I plan to stay in Washington, D.C.?
- Who looks after the drainage tube, and who takes it out?
- What is my risk of stones returning, and how can I reduce it?
- What happens if the team cannot preserve my gallbladder during the procedure?
Frequently asked questions
Below are short answers to the questions UAE patients ask most. You can also find more answers on our FAQ page.
Can I remove my gallstones and keep my gallbladder?
Yes, in some cases. Gallbladder-preserving procedures such as GO-SCOPE take out the stones through a small opening in the skin, while the gallbladder stays in place. However, a specialist must review your scans to confirm that you are suitable.
Is GO-SCOPE available in the UAE?
No. Dr. John Smirniotopoulos performs GO-SCOPE only in Washington, D.C., United States. Therefore, UAE patients start with a consultation and records review, then travel for the procedure if it suits them.
How long is the hospital stay after GO-SCOPE?
In the main published study of 51 patients, the average hospital stay was 23 hours. As a result, most patients went home within about a day of the procedure.
How long does the drainage tube stay in after GO-SCOPE?
In the published studies, the team took out the drainage tube after an average of 21.8 days, or about three weeks. In contrast, high-risk patients who could not have surgery kept it for an average of 35 days.
Can gallstones come back after gallbladder-preserving treatment?
Yes, they can, because the gallbladder remains. Also, published follow-up is still short, with a median of 208 days. If new stones form, doctors can repeat GO-SCOPE, and a healthy diet may help reduce the risk.
Is GO-SCOPE painful?
During the procedure, the team uses conscious sedation or light anaesthesia. Afterwards, most patients report mild discomfort and rarely need strong pain medication.
Who is not suitable for gallbladder-preserving treatment?
Some patients do better with conventional gallbladder removal. Suitability depends on your stones, the condition of your gallbladder and your general health. Therefore, a specialist must review your scans first.
Conclusion: is gallbladder-preserving treatment right for you?
Gallbladder-preserving gallstone treatment gives some patients a way to treat gallstone pain while they keep the gallbladder. Published GO-SCOPE studies report complete stone removal in every case, short hospital stays and strong symptom relief. However, they also show that complications can occur and that a drainage tube stays in place for around three weeks.
For UAE patients, the deciding factors are medical suitability and the ability to travel to Washington, D.C. Therefore, the first step is a specialist review of your scans.
Ready to find out if GO-SCOPE may suit you? Book a consultation and share your recent scans for review.
This article gives general information and is not medical advice. Always discuss treatment options with a qualified doctor.