Should My Father Have Gallbladder Surgery for Gallstones? Expert Advice Needed

Should the gallbladder be removed for gallstones? Inquire about capsule supplements recommended by pharmacies for gallstones?

Hello Doctor, my father is 58 years old, does not smoke or drink, and runs 5 kilometers daily.
He has mild hypertension (systolic blood pressure around 130-150, diastolic pressure mostly between 70-90).
Last week, an ultrasound during a health check at the hospital revealed two gallstones, each about 2 centimeters in size.
So far, my father feels normal and has no discomfort.
A physician at the gastroenterology clinic suggested gallbladder removal, but my father later consulted a pharmacy, where the owner advised against surgery and recommended taking "Lecithin" capsules instead.
Therefore, I would like to ask for your professional advice: should he have his gallbladder removed before it becomes inflamed, or can he wait until he experiences discomfort? Additionally, the packaging of the "Lecithin" capsules looks somewhat strange; it claims to be produced in Germany, but the label states it is manufactured by "United Pharmaceutical Company, USA." I am unsure whether to recommend that my father stop taking this product.
I would appreciate your advice, thank you!

Eva, 20~29 year old female. Ask Date: 2020/10/26

Dr. Chen Shidian reply Gastroenterology and Hepatology

Asymptomatic gallstones can be monitored; however, if there is discomfort in the right upper abdomen or under the right rib after meals, it is advisable to seek medical attention promptly (as this may indicate that a gallstone is lodged at the cystic duct).
There are currently no recommended dietary supplements for this condition.

Reply Date: 2020/10/26

More Info

When considering whether your father should undergo gallbladder surgery for gallstones, several factors need to be evaluated. Your father, at 58 years old, is relatively young and appears to be in good health, with no significant symptoms reported. The presence of two gallstones, each approximately 2 cm in size, raises the question of whether surgical intervention is necessary at this time.

Understanding Gallstones and Surgical Indications
Gallstones can be classified as symptomatic or asymptomatic. In asymptomatic cases, the risk of developing complications such as acute cholecystitis, pancreatitis, or biliary colic is relatively low. The general consensus among medical professionals is that the risk of complications from asymptomatic gallstones is about 1-2% per year. However, the size of the stones and the patient's overall health must also be considered.

In your father's case, the stones are of a significant size (2 cm), which can increase the likelihood of complications. Larger stones are more likely to cause blockages in the bile duct, leading to pain and potential inflammation of the gallbladder. If your father has experienced any episodes of pain, especially after meals, or if he has had any symptoms like jaundice or fever, these would be strong indicators for surgical intervention.

Recommendations for Surgery
The recommendation from the gastroenterologist to consider surgery is based on the potential risks associated with leaving the gallstones untreated. Prophylactic cholecystectomy (gallbladder removal) is often advised in cases where there is a significant risk of complications, especially with stones of this size. It is generally better to address the issue before any acute symptoms arise, as emergency surgeries can carry higher risks and complications.

Non-Surgical Alternatives
The suggestion from the pharmacy regarding the use of "Lecithin" capsules as a non-surgical remedy is worth discussing with a healthcare provider. While some supplements may help in managing gallstone symptoms or preventing new stones, they are not a substitute for surgical intervention in cases where surgery is indicated. It is essential to approach such supplements with caution, especially if the labeling and manufacturing details are unclear, as you mentioned regarding the product's origin.

Conclusion and Next Steps
In conclusion, given your father's age, health status, and the size of the gallstones, it would be prudent to have a detailed discussion with his healthcare provider about the risks and benefits of surgery versus observation. If he remains asymptomatic, a watchful waiting approach may be considered, but this should be closely monitored with regular follow-ups. If any symptoms develop, or if there are changes in his health status, surgical intervention may become necessary.

It is advisable to seek a second opinion from another qualified gastroenterologist or surgeon, especially if there are uncertainties regarding the recommendations. Additionally, ensure that any supplements he considers taking are discussed with his healthcare provider to avoid any potential interactions or complications.

Ultimately, the decision should be made collaboratively with his healthcare team, taking into account his personal preferences and overall health condition.

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