Is it mandatory to get immediate surgery for gallstones?

Question

Hello doctor,

My friend is having a gall bladder stone. We consulted few doctors, some are saying the immediate operation is needed otherwise it will be cancerous and some are saying no immediate action is required. She is having pain in her right side of the upper abdomen and also in the middle. I am attaching her ultrasound report. Please tell me about her condition. During this pandemic, we are not able to go outside and consult the doctor.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern about symptoms complex and ultrasound findings and whether surgery is the answer to your problem.

Well, first of all, I want to clear that you do not have stones in the gallbladder. They are concretions. It is a medical term and they are called microlithiasis (gall bladder stones less than 3 mm in size). So the possibility of developing cholecystitis (gall bladder inflammation) is very low. However, this microlithiasis can cause pancreatitis (inflammation of the pancreas which is a gland sitting over the back of the abdomen).

Thirdly, the pain can be secondary to the functional gall bladder problem, where the gall bladder is naturally slow resulting in damping of bile (yellow secretion produced by the liver and stored within gallbladder) and production of small concretions such as in y our case.

So I would ask you to get a few blood tests to confirm whether you have pain due to pancreatitis. I also want that you should discuss to me in more detail about your pain, as only proper history can give me a clue towards your problem whether gall bladder inflammation, pancreatitis, or functional gall bladder disorder even before any further testing.

Since the ultrasound findings and your symptoms are not correlated very well, there is no point in discussing the role of surgery. But I just want to assure you that you probably need no surgery, so do not worry about it.

I suggest you some tests, please get it done, then I would recommend you some lifestyle changes and a medical treatment that can help you resolve your minor stones within the gallbladder.

I hope this helps.