Not a problem. No imposition at all, anytime. I did some reading about ACV and I think it falls into the category of "possibly helpful (not miraculous), probably not harmful". There's no good evidence to suggest that it's helpful though there are theoretical benefits. The mechanism is supposedly that it thins the bile and softens up the gallstones. The theoretical problem is that this might make the stones more likely to get out of the gallbladder and into the common bile duct. This can plug the duct and also cause pancreatitis (gallstones are the no 1 cause of pancreatitis in the US). OTOH, there is an approved medication (ursadilol) that can dissolve gallstones and theoretically could cause similar problems and I've never heard anyone express that concern. Ursadilol is expensive, has its own side effects, and gallstones tend to reform once the medicaton is discontinued. For this reason, it is used mainly in pts that are a prohibitive surgical risk. Also it only works for cholesterol stones (most common).
Cholesystectomy is routine and safe (though not without real risks however) and has a quick recovery when performed minimally invasively. It is useful in several circumstances: acute cholecystitis (people go to the hospital with unrelenting pain etc), multiple frequent standard attacks, or when chronic low level symptoms become lifestyle limiting. Obviously the last category is fairly subjective and only the pt can decide when he's "had enough". It is easier and safer to have the GB out when the GB is not inflamed. However, it seems that it is impossible to predict the behavior of an individual pt's future symptoms.
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