What is a common nonoperative management option for uncomplicated biliary colic?

• A. Immediate cholecystectomy
• B. Pain control and observation
• C. Broad-spectrum antibiotics
• D. ERCP

Answer: (B)

Uncomplicated biliary colic is caused by a gallstone intermittently blocking the cystic duct, producing episodic right upper quadrant pain without infection or ductal obstruction. In a stable patient, the goal of nonoperative management is to relieve symptoms and monitor for signs of complications. Pain control with anti-inflammatory medication (and sometimes short-acting analgesics) is the mainstay, along with observation and reassurance. Antibiotics aren’t indicated because there’s no infection, and ERCP isn’t appropriate because there’s no ductal obstruction requiring stone extraction. If episodes recur or become more frequent, elective laparoscopic cholecystectomy is typically planned to prevent future attacks.