If you have recently been diagnosed with gallstones, it is natural to wonder what comes next. Hearing that surgery is one possible treatment can feel daunting, particularly if you are hoping to avoid an operation.
Rather than taking a one size fits all approach, doctors consider a range of factors before recommending treatment. Understanding these considerations can make it easier to have an informed discussion about your options.
Do All Gallstones Need Treatment?
Not every gallstone requires treatment. In many cases, gallstone removal is only recommended when the stones begin causing symptoms or lead to complications. Gallstones that do not cause symptoms are known as asymptomatic gallstones. Many people live with them for years without experiencing any discomfort or health issues. In these situations, surgery is usually not recommended because the potential risks of an operation may outweigh the benefits.
Instead, your doctor may advise observation while explaining what symptoms to watch for in the future.
When Is Surgery Usually Recommended?
Surgery is often recommended when gallstones repeatedly block the flow of bile or trigger inflammation. Removing the gallbladder addresses the source of the problem and helps prevent future attacks.
Recurrent Gallstone Pain
The most common symptom is biliary colic, which typically causes sudden pain in the upper right abdomen or centre of the abdomen. The pain often develops after eating a fatty meal and may last from several minutes to several hours.
Although the pain may settle on its own, repeated episodes often indicate that the stones will continue causing problems.
Inflammation of the Gallbladder
When a gallstone becomes trapped, it can lead to inflammation of the gallbladder, known as acute cholecystitis.
Symptoms may include:
- Severe and persistent abdominal pain
- Fever
- Nausea or vomiting
- Tenderness over the right upper abdomen
Acute cholecystitis usually requires prompt medical assessment and often surgical treatment.
Other Gallstone Complications
Gallstones can also move into the bile ducts and cause more serious conditions, including:
- Infection of the bile ducts
- Inflammation of the pancreas (gallstone pancreatitis)
- Jaundice caused by blockage of bile flow
These complications often require urgent treatment and may involve additional procedures before gallbladder surgery is performed.
Why Remove the Gallbladder Instead of Just the Stones?
Many people wonder why surgeons recommend removing the entire gallbladder rather than simply taking out the stones. The reason is that gallstones form inside the gallbladder. Removing only the stones leaves the gallbladder behind, allowing new stones to develop over time. This means symptoms are likely to return.
Gallbladder removal surgery, known as cholecystectomy, removes both the stones and the organ where they form. This significantly reduces the risk of future gallstone-related problems. Fortunately, the gallbladder is not essential for digestion. After surgery, bile flows directly from the liver into the small intestine and most people continue eating a normal diet once they have recovered.
What Happens If You Decide to Wait?
If you have already experienced gallstone attacks, choosing to wait carries some potential risks. While some people may remain symptom-free for a period of time, others develop more frequent pain or complications that require emergency treatment.
Seek medical attention promptly if you experience:
- Severe abdominal pain lasting several hours
- Fever with abdominal pain
- Yellowing of the skin or eyes
- Persistent vomiting
These symptoms may indicate a complication that requires urgent assessment.
Making an Informed Decision About Gallstone Treatment
While it may be tempting to avoid surgery, leaving symptomatic gallstones untreated can sometimes lead to recurring attacks or more serious complications. Understanding your individual risk allows you to weigh the benefits of treatment against the risks of waiting, so you can make a decision with greater confidence.
At the Hepatobiliary & Pancreatic Surgery Centre in Singapore, treatment is provided by Dr Wong Jen San, who performs a comprehensive assessment to determine whether surgery is appropriate for your condition. If you have been diagnosed with gallstones or are experiencing recurring upper abdominal pain, schedule a consultation to discuss your symptoms and the treatment options available to you.
Frequently Asked Questions (FAQs) About Gallstone Surgery
Can gallstones come back after gallbladder surgery?
Once the gallbladder has been removed, gallstones cannot form inside it again because the organ is no longer present. In uncommon cases, stones may develop within the bile ducts, although this is much less common than gallbladder stones.
Will I need to follow a special diet after surgery?
Most people gradually return to their usual diet after recovery. Some may temporarily experience loose stools or mild digestive changes, particularly after fatty meals, but these symptoms often improve over time as the body adapts.
Are there medicines that can dissolve gallstones?
Certain medications can dissolve specific types of cholesterol gallstones, but they are only suitable for a small number of patients. Treatment usually takes many months and gallstones may return after the medication is stopped. Surgery remains the definitive treatment for symptomatic gallstones.