Gallstones, or cholelithiasis, are stones that form within the gallbladder, a small organ beneath the liver. Only 25% for Gallstones become symptomatic 75% of patients have no symptoms (Asymptomatic). Addressing this issue poses a unique difficulty when making surgical choices.
Asymptomatic gallstones are typically discovered incidentally during ultrasound evaluation for unrelated medical purposes..
Natural History and Risks
. Dr. Srikanth Gadiyaram senior surgeon with over 20 years of experience estimates that 2% per year of asymptomatic patients develops symptoms during follow up these symptoms include biliary colic, acute cholecystitis or pancreatitis.
Potential Risks and Complications
Although gallstones that do not cause any symptoms usually aren’t harmful, they can pose problems if they block the bile ducts. Problems that could arise include:
- Acute cholecystitis is an inflammation of the gallbladder that can lead to infection, fever, and intense abdominal pain.
- Jaundice and cholangitis are possible outcomes of choledocholithiasis, which occurs when gallstones enter the common bile duct.
- Inflammation of the pancreas, sometimes known as pancreatitis, is a potentially fatal condition.
The choice to surgically remove asymptomatic gallstones requires careful consideration of the risks and benefits of the procedure in light of these hazards.
Surgical Considerations
Indications for Surgery
The primary surgical treatment for gallstones is cholecystectomy, the removal of the gallbladder. For asymptomatic gallstones, surgery is generally not recommended unless specific conditions are met:
● High Risk of Complications: Patients with a high risk of developing complications, such as those with immunocompromised individuals, or patients with sickle cell disease, may benefit from prophylactic cholecystectomy.
● Large Gallstones: Stones larger than 2-3 cm have a higher likelihood of causing symptoms or complications and may warrant surgical removal.
● Porcelain Gallbladder: This condition involves extensive calcification of the gallbladder wall and is associated with a higher risk of gallbladder cancer. Cholecystectomy is often recommended in these cases.
● Pediatric Patients: Children with asymptomatic gallstones, especially those with hemolytic disorders, may be more prone to complications, and early surgical intervention may be considered.
Surgical Techniques
The standard surgical approach is laparoscopic cholecystectomy, a minimally invasive procedure that offers faster recovery, less postoperative pain, and shorter hospital stays compared to open surgery. An open cholecystectomy can be done when laparoscopic surgery isn’t an option.
A balanced strategy for surgically managing asymptomatic gallstones must consider minimal consequences, patient risk factors, and operation pros and cons. Prophylactic cholecystectomy is rarely recommended for symptom-free patients. High-risk patients may benefit from surgery. The patient and healthcare provider must communicate and decide together to get the best results.
Minimal Invasive Surgeries are provided at Sahasra Hospitals, Jayanagar
Expert care and a seamless road to recovery are provided by our staff at Sahasra Hospital. At Sahasra Hospital, we have gastrointestinal experts who can diagnose and treat any problem you may be experiencing. Call 9880105829 to schedule an appointment.
