This article is professionally consulted by Master, Doctor - Gastrointestinal Surgeon - Department of General Surgery - Vinmec Ha Long International General Hospital.
There is no specific size that dictates when gallstones require surgery. Not all gallstone cases need surgical intervention. It depends on the complications caused by the stones and the patient's health status. Doctors will then make the most appropriate recommendations.
1. When Do Gallstones Require Surgery?
In some cases, gallstones as small as a few millimeters necessitate surgery, while in others, stones as large as 1-2 cm do not require surgical intervention.
Liver and gallbladder specialists explain: “For asymptomatic gallstones, surgery is not needed. Conversely, for cases where gallstones cause chronic cholecystitis or acute complications that threaten life, even small stones like grains of sand may warrant gallbladder removal. Therefore, gallbladder removal is not solely based on stone size.”
Furthermore, gallbladder surgery or stone removal is only indicated when stones cause acute complications or pose potential risks (e.g., large gallbladder polyps, multiple polyps). Elderly patients with large gallstones may also be advised to undergo gallbladder removal to prevent complications, as their health might not withstand surgery in the future.
All symptomatic gallstone cases require treatment regardless of stone size and quantity. For asymptomatic gallstones, the role of gallbladder removal and other treatment methods is unclear. However, in cases with a high risk of gallbladder cancer, such as porcelain gallbladder, stones combined with polyps larger than 10 mm, or stones larger than 25 mm, surgery may be necessary.
2. When Should Gallstone Surgery Be Performed?
Gallstone removal is often done using laparoscopy Gallstone removal is often done using laparoscopy Most gallstones are silent and rarely cause pain, so they do not require intervention. However, the gallbladder needs to be removed when stones block the bile ducts, causing cholecystitis. Today, laparoscopic cholecystectomy is a common and minimally invasive surgery to treat gallstones.
Although surgery only removes gallstones and does not address the underlying cause, evidence shows that about 50% of cases treated with surgery will experience gallstone recurrence within the next 3-5 years.
Despite this, surgery remains the optimal solution to relieve patients from pain and minimize the dangers of complications in the following cases:
- Recurrent cholecystitis caused by gallstones leads to frequent severe abdominal pain, fever, nausea, and bloating, affecting health.
- Porcelain gallbladder (thickened, calcified walls) loses its ability to contract and concentrate bile.
- Stones lodged in narrow areas such as the gallbladder neck cause frequent pain and inflammation.
- Gallstones combined with polyps larger than 10 mm.
- Large stones over 2 cm or stones occupying 2/3 of the gallbladder volume, affecting its function.
- Special cases such as diabetic patients with gallstones are often advised to have their gallbladder removed even without symptoms to prevent future risks.
3. Gallstone Surgery at Vinmec Nha Trang International General Hospital
If you have symptoms of gallstones, you should visit Vinmec International General Hospital for an examination. Vinmec frequently collaborates with medical centers in advanced countries such as Japan, France, the USA, and Singapore, for technology transfer and professional exchange. This allows Vinmec to stay updated with the latest medical advancements for diagnosis and treatment.
Vinmec International General Hospital continuously updates global medical advancements for treatment Vinmec International General Hospital continuously updates global medical advancements for treatment Especially, the laparoscopic gallstone removal techniques at the hospital help patients recover quickly and comfortably, with the following advantages:
- Success rate up to 98%
- Painless surgery and post-operative period
- Professional medical staff care
- Performed by leading gastrointestinal and hepatobiliary specialists
- State-of-the-art laparoscopic surgery equipment in the region
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