What kind of gallstones require surgery?

Surgery is usually considered for gallstones that present with severe symptoms, cholecystitis, bile duct obstruction, or infection. When gallstones cause severe abdominal pain, fever, jaundice, or other complications, surgery may be the most effective solution. Timely surgical intervention is also recommended for gallstones that recur and cannot be relieved by medication or other conservative treatments.

1) Symptoms are severe and affect the quality of life

When gallstones cause severe right upper abdominal or back pain (biliary colic), persistent vomiting, and digestive difficulties, even if there are no signs of inflammation or infection, these patients should consider surgical treatment, especially when it has a significant impact on their life and work. Currently, the most common surgical option is laparoscopic cholecystectomy, which is characterized by less trauma and faster recovery.

2) Acute cholecystitis or common bile duct stones

Acute cholecystitis is a common complication of gallstones and may cause fever, chills, and significant right upper quadrant tenderness. If gallstones become lodged in the gallbladder or common bile duct, resulting in obstruction of bile flow, jaundice or liver function abnormalities may also occur. Patients with this condition usually require emergency surgery to prevent further deterioration or development of gallstone pancreatitis.

3) Severe gallbladder function impairment or combined with other risk factors

Patients with gallbladder atrophy or significant decline in function may have an increased risk of gallbladder cancer due to gallstones, even if they do not have significant pain symptoms, especially when the gallstones are larger than 3 cm in diameter. If the patient is older or has high-risk diseases such as diabetes or immunosuppression, asymptomatic "silent" gallstones may also develop into serious problems. In such cases, doctors may recommend preventive surgery.

How to choose the appropriate treatment?

Depending on the condition, the treatment of gallstones includes laparoscopic cholecystectomy (minimally invasive surgery, suitable for most patients); endoscopic retrograde cholangiopancreatography (ERCP, used to treat common bile duct stones); in special cases, open cholecystectomy can also be used, which is more suitable for patients with complex abdominal conditions. If surgery is not suitable or temporarily unavailable, doctors may provide conservative treatments such as drug dissolution and extracorporeal shock wave lithotripsy, but the effects are generally limited.

For patients with gallstones whose symptoms are severe, endanger their health, or have related complications, surgery is the most effective treatment. In daily life, if you find gallstones, it is recommended to have regular checkups. If the discomfort symptoms worsen, you should seek medical help as soon as possible to avoid delaying the disease.