Does the size of gallbladder stones influence the need for surgery?
Gallbladder stones come in different sizes and numbers and this continues to be an ongoing question on how it influences the decision for surgery.
In this blog, we’ll break down ‘if ‘ the size of gallbladder stones determines whether surgery is necessary.
What are Gallbladder Stones?
Gallbladder stones, also known as gallstones, are solid particles forming in the gallbladder, is a small organ located under the liver. The gallbladder acts as a pouch holding bile, a green-yellow liquid that helps with digestion.
Gallstones can vary significantly in size, from tiny sand-like particles to larger stones resembling pebbles. They are typically composed of either cholesterol or bilirubin, a substance produced from the breakdown of red blood cells.
While many individuals with gallstones remain asymptomatic and experience no discomfort, others may develop distressing symptoms that require proper diagnosis and treatment.
What are the symptoms of Gallbladder Stones?
Gallbladder stones symptoms can vary depending on the size and type of the stones and whether they cause any complications. Some people with stones in gallbladder experience no symptoms at all, a condition known as “silent” gallstones.
However, when symptoms do occur, they may include:
- Pain in the abdomen that is worse after food and more on the RIGHT side
- Nausea and vomiting
- Fever and chills
- Pain going into the back
- Jaundice
- Non specific upper abdo pain, distension etc (Rarely related to gallstones)
If you experience any of these symptoms of gallbladder stones, seeking medical advice is crucial for an accurate diagnosis and appropriate treatment options.
How are Gallbladder Stones diagnosed?
Dr Balaji will ask about your symptoms, including any abdominal pain, nausea, or jaundice. He may conduct a physical examination to check for signs of tenderness in the abdomen, especially in the upper right quadrant, where the gallbladder is located.
Diagnostic tests will allow him to look inside your body, which may be used during the checkup. These tests include:
- Ultrasound creates gallbladder images and can identify the presence, size, and number of stones.
- CT Scans offer detailed cross-sectional images of the abdomen, allowing to help identify gallstones and any potential complications.
- Magnetic Resonance Imaging (MRI)- MRCP provides detailed images of the bile ducts and gallbladder.
- Blood tests help detect signs of infection, inflammation, or liver function issues related to gallstones.
- Radionuclide scan of the gallbladder to reveal indications of illness or bile duct blockage caused by stones.
Size of Gallstones and the need for surgery?
It is the SYMPTOMS, SIGNS AND COMPLICATIONS that determine the need for gallbladder stone surgery more than the mere SIZE or NUMBER of stones.
In someone who is completely without any symptoms ( for example when the gallstones are diagnosed when performing a scan for some other reason other than symptoms related to gallstones), surgery is not advised irrespective of the size or number. However patients are to be made aware of the stones and to reach out if symptoms arise at any stage.
Larger stones may tend to cause symptoms more often and early. However if there are no symptoms even from large stones they can be left alone. If symptomatics they can cause simple biliary colic or inflammation (cholecystitis)
Smaller symptomatic stones are relatively more dangerous ones as they can travel beyond the gall bladder and get blocked in the bile pipe causing jaundice, cholangitis etc.
The smallest stones can be said as the most dangerous which have a potential to cause pancreatitis which is the most dreaded complication from gallstones. However not all small stones cause pancreatitis and they may also pass away on their own.
Key points to consider:
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What are the different treatment options for gallbladder stones?
Watchful waiting: For asymptomatic gallstones or those causing minimal discomfort, it may be recommended that you monitor the condition without immediate intervention.
Lifestyle and dietary changes: Making adjustments such as adopting a low-fat diet may help manage symptoms or prevent the formation of new stones but are not primary treatments for existing gallstones.
Oral bile acid pills: These can help dissolve cholesterol gallstones over time. Although less commonly used, they are an option for gallbladder stones treatment without operation.
Endoscopic Retrograde Cholangiopancreatography (ERCP): ERCP is used to remove stones from the bile ducts, not from the gallbladder itself. An endoscope is utilized to locate and extract stones from the bile duct during this procedure.
Gallbladder stones surgery or cholecystectomy: The most effective treatment for symptomatic gallstones. This surgery involves removing the gallbladder. It can be performed using:
- Laparoscopic cholecystectomy: A minimally invasive technique with smaller incisions and a quicker recovery time.
Open cholecystectomy: A more invasive approach with a larger incision, used if laparoscopic surgery is not possible.
Consult Dr Balaji Nagammapudur for gallbladder treatment in Dubai
For expert advice on treating your gallbladder stones appropriately, consult Dr Balaji Nagammaoudur in Dubai.
With over 30 years of experience as a consultant surgeon specializing in Upper GI and oesophageal surgery, Dr Balaji brings unmatched expertise to managing gallbladder conditions. Whether you’re experiencing symptomatic gallstones or seeking comprehensive advice on treatment options, Dr Balaji’s extensive experience and advanced skills offer a reliable path to recovery.
Book your appointment for a comprehensive evaluation and personalized treatment plan today!