Gallbladder Stones: When to Consider Surgery? - Gastroenterology and Hepatology

Gallbladder surgery

Hello, for the past 2-3 years, I have frequently experienced abdominal bloating and discomfort after meals.
Taking antacids or medications for bloating is sometimes effective and sometimes not.
A few months ago, I had severe bloating and a feeling of pressure, along with a burning sensation in my upper abdomen.
Antacids did not help.
An ultrasound revealed a 0.8 cm gallstone near the bile duct, which was described as a "time bomb." An endoscopy showed only superficial gastritis.
I have been taking antispasmodics and medications to dissolve the stone, which have improved my condition.
The doctor mentioned surgery would be considered if symptoms worsen.
However, I still experience discomfort after eating, and I often feel nauseous or have acid reflux around 5-6 PM or at night.
Sometimes, I also experience leg cramps, though they are not painful.
Should I consider surgery given these symptoms?

Niming, 40~49 year old female. Ask Date: 2023/10/19

Dr. Chen Shidian reply Gastroenterology and Hepatology

It does not resemble gallstone symptoms; we can try medication management.

Reply Date: 2023/10/19

More Info

When it comes to gallbladder stones, also known as gallstones, the decision to undergo surgery can be complex and often depends on a variety of factors, including the presence and severity of symptoms, the size and location of the stones, and the overall health of the patient. Your situation, characterized by recurrent abdominal discomfort, particularly after meals, and the presence of a gallstone measuring 0.8 cm near the bile duct, raises important considerations regarding the timing and necessity of surgical intervention.

Understanding Gallstones and Symptoms
Gallstones can be asymptomatic, meaning many individuals may carry them without experiencing any noticeable issues. However, when symptoms do occur, they can range from mild discomfort to severe pain, often referred to as biliary colic. Common symptoms include:
- Right upper abdominal pain: This pain may occur after eating, particularly after consuming fatty meals.

- Nausea or vomiting: These symptoms can accompany episodes of pain.

- Indigestion or bloating: As you've described, feelings of fullness or bloating after meals can be indicative of gallbladder issues.

- Jaundice: If a stone obstructs the bile duct, it can lead to jaundice, characterized by yellowing of the skin and eyes.

When to Consider Surgery
The general medical consensus suggests that surgery, specifically laparoscopic cholecystectomy, is indicated in the following scenarios:
1. Symptomatic Gallstones: If you experience recurrent symptoms that interfere with your daily life, such as the abdominal pain and discomfort you described, this may warrant surgical intervention. The presence of a stone near the bile duct increases the risk of complications, such as acute cholecystitis or pancreatitis.

2. Complications: If there are signs of complications, such as fever, jaundice, or severe abdominal pain, surgery may be necessary to prevent further health issues.

3. Size and Location of Stones: Stones that are larger than 2 cm or located near the bile duct are more likely to cause complications and may necessitate earlier surgical intervention.

4. Patient's Overall Health: The decision also depends on your overall health status. If you have other medical conditions that could complicate surgery or anesthesia, this should be discussed with your healthcare provider.

Current Symptoms and Surgical Consideration
In your case, the recurrent symptoms of bloating, discomfort after meals, and the presence of a gallstone suggest that you may be experiencing symptomatic gallstones. While your physician has advised waiting for surgery until symptoms worsen, it is essential to weigh the risks of potential complications against the benefits of surgical intervention.
Given that you are experiencing significant discomfort that affects your quality of life, it may be reasonable to consider discussing the option of surgery with your healthcare provider. You might want to ask about:
- The likelihood of complications if surgery is delayed.

- The potential for your symptoms to worsen over time, leading to more severe health issues.

- The risks associated with surgery, especially considering your current symptoms and any other health conditions you may have.

Conclusion
In summary, while not every case of gallstones requires surgery, your symptoms and the characteristics of your gallstone suggest that you may be a candidate for surgical intervention. It is crucial to have an open discussion with your healthcare provider about your symptoms, the risks of waiting, and the potential benefits of surgery. This will help you make an informed decision that aligns with your health needs and lifestyle. Remember, addressing gallstones proactively can prevent more severe complications in the future.

Similar Q&A

Gallbladder Stones: To Operate or Not? Key Considerations and Timing

The patient has a 10-year history of gallbladder stones and has experienced occasional right upper abdominal pain after meals for the past 2 years. There was one episode of fever and vomiting during an attack 2 weeks ago, which spontaneously subsided after supportive treatment at...

Dr. Xiao Yongxun reply Internal Medicine
Dear FRED: 1. The management of asymptomatic gallstones remains controversial. The risk of developing symptoms or complications that require surgery is quite low, around 1 to 2 percent per year, in most asymptomatic gallstone patients. 2. Recommendations for prophylactic cholec...

Gallbladder Removal: When Is Surgery Necessary for Gallstones?

Hello, doctor. I have gastroesophageal reflux disease, and recently I've experienced right upper abdominal pain twice within a week. The emergency department diagnosed me with gallstones leading to cholecystitis, but my blood tests are normal. I would like to know your opini...

Dr. Hu Guozheng reply Gastroenterology and Hepatology
The primary treatment for symptomatic gallstones is cholecystectomy. If a physician assesses that a patient is not suitable for surgery, extracorporeal shock wave lithotripsy combined with medication can be considered. Additionally, lifestyle and dietary modifications are necessa...

Managing Gallstones: When to Consider Surgery and Your Options

Hello Dr. Chen, I have been diagnosed with gallstones, approximately 7 to 8 in number. I asked my doctor if surgery is necessary, and he said to wait until I experience pain before considering it. He mentioned that it is possible to live with them without issues for a lifetime. H...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello, the indications for gallstone surgery are determined by symptoms rather than the number or size of the stones. In principle, if there are more than one episode per year, that is an indication for surgery. If there is no history of abdominal surgery, laparoscopic cholecyste...

Should Surgery Be Considered for Gallbladder Atrophy?

Hello Dr. Chen: My father previously experienced severe pain in the upper abdomen and first went to Hospital A for an ultrasound, which revealed a thickened gallbladder. The physician at Hospital A recommended surgery. He then went to Hospital B for further evaluation, where it w...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello, the prerequisite for an ultrasound examination of the gallbladder is fasting for at least 6-8 hours. If the examination reveals thickening of the gallbladder wall or atrophy while fasting, it often suggests the presence of gallstones along with chronic cholecystitis. In th...