Should Surgery Be Considered for Gallbladder Atrophy?

Is cholecystectomy necessary 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 was found that the gallbladder was atrophied.
The physician at Hospital B stated that surgery is optional.
I would like to know if both conditions require surgical intervention, and if surgery is not performed, are there any potential complications or sequelae? Thank you for your response.

rita, 30~39 year old female. Ask Date: 2009/03/26

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 this situation, the gallbladder's contraction function is already lost, and some physicians may recommend surgery.
If surgery is not performed, the cholecystitis may recur.
Additionally, it is not possible to further differentiate whether the thickened gallbladder has other diseases under ultrasound.
Therefore, choosing surgery is justified.
Best regards, Dr.
Chi-Feng Chen, Taoyuan Hospital, Department of Health.

Reply Date: 2009/03/26

More Info

When considering whether surgery should be performed for gallbladder atrophy, it is essential to understand the underlying conditions and potential complications associated with this diagnosis. Gallbladder atrophy, or gallbladder shrinkage, can occur due to various reasons, including chronic inflammation, gallstones, or other biliary tract diseases. The decision to proceed with surgery often depends on the presence of symptoms, the degree of gallbladder dysfunction, and the risk of complications.

In your father's case, the initial ultrasound indicated a thickened gallbladder wall, which can suggest inflammation or other pathological changes. The subsequent diagnosis of gallbladder atrophy raises questions about the gallbladder's functionality. If the gallbladder is not functioning properly, it may not effectively store and release bile, which can lead to digestive issues and potential complications.

Surgery, typically in the form of cholecystectomy (gallbladder removal), is often recommended when there are significant symptoms such as biliary colic, recurrent pancreatitis, or complications like acute cholecystitis. If your father is experiencing severe abdominal pain or other related symptoms, surgical intervention may be warranted to alleviate these issues and prevent further complications.

On the other hand, if the gallbladder is atrophied but asymptomatic, the decision to operate becomes more nuanced. Some physicians may recommend a conservative approach, monitoring the condition without immediate surgical intervention, especially if there are no signs of complications. However, it is crucial to consider that gallbladder atrophy can sometimes lead to complications such as chronic pain, bile duct obstruction, or even an increased risk of gallbladder cancer in rare cases.

If surgery is not performed, the risk of complications largely depends on the individual’s overall health, the presence of other medical conditions, and the specific reasons for the gallbladder atrophy. Regular follow-up with imaging studies and clinical evaluations may be necessary to monitor any changes in the gallbladder or surrounding structures.

In conclusion, the decision to proceed with surgery for gallbladder atrophy should be made collaboratively between your father and his healthcare provider, taking into account his symptoms, overall health, and the potential risks and benefits of surgical intervention. If there are any doubts or concerns, seeking a second opinion from a gastroenterologist or a surgeon specializing in biliary diseases may provide additional clarity and guidance. It is always essential to weigh the risks of surgery against the potential for complications if the condition is left untreated.

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