Gallstones: When to have surgery?

The article was professionally consulted by Doctor Phan Thanh Nguyen - Vinmec Central Park International General Hospital.

Gallstones are common in women over the age of 40 who are obese. The disease is difficult to detect because the initial symptoms are very mild, almost absent. By the time there is significant pain, the stone size is usually quite large. What are the treatments for gallstones? When to have gallbladder surgery? Let's answer these questions in the article below.

The gallbladder is located below the right lobe of the liver, blue in color, small in size from 30 to 60ml. The gallbladder is responsible for storing the bile secreted by the liver and concentrating it. When food enters the stomach, the gallbladder will contract to push bile into the bile ducts, down the duodenum to help digest fats in food.

Gallstones are solid crystals made up of components in bile. Without early treatment, gallstones will continue to grow in size and number. At first it can be as small as a grain of sand, to the size of a pea, in some cases gallstones are as big as a golf ball. Patients can have one or more stones at the same time. Gallstones interfere with the secretion of bile, stones can also cause inflammation of the gallbladder, affecting the liver and pancreas.

Gallstone causes the patient to feel pain in the right lower quadrant and epigastrium. Pain is intermittent, each episode usually lasts a few minutes, even a few hours. Patients often have pain after eating, especially a meal with a lot of fat. Accompanying the pain is a feeling of nausea or vomiting.
Treatment of gallstones has 2 methods: surgical and non-surgical. So when is surgery necessary to treat gallstones?
Usually, gallstones have no symptoms, do not cause too much pain for the patient, do not need surgery. Patients can choose between surgery and the use of stone-dissolving drugs, extracorporeal shock wave lithotripsy, stone dissolution and percutaneous stone removal, endoscopic gallbladder removal... Medical treatment in Vietnam is mainly using drugs to dissolve stones, but the effect is not high because the stones in our country are mainly bile pigment stones, unlike in Western countries, mainly cholesterol stones. With lithotripsy or endoscopic gallstone removal, the outcome is not high depending on the type of stone, the size of the stone and the anatomy of the bile duct. In addition, these treatment methods all share the common feature of leaving the gallbladder, which will create stones in the future, which takes a long time and is not effective.
If gallstones have long-lasting painful symptoms, cause chronic cholecystitis or potentially life-threatening complications, surgery is necessary, regardless of the size of the gallbladder stones. small or large honey. In addition, cases of gallstones are asymptomatic but patients have stones larger than 25mm, gallbladder has many stones, gallbladder stones are accompanied by gallbladder polyps larger than 10mm, or are at risk of gallbladder cancer. early surgery is also required.

With many outstanding advantages, laparoscopic cholecystectomy is the gold standard in the treatment of gallstones.
Advantages of laparoscopic cholecystectomy:
Laparoscopic surgery is less painful. Small incision. Quick surgery time, less damage. The patient recovered quickly. The rate of complications and adverse events is low.

After laparoscopic cholecystectomy, some patients will have transient digestive disorders such as slow digestion, diarrhea... However, these symptoms will gradually disappear after 3 to 6 months. Therefore, postoperative patients need to have a reasonable diet, limiting fat and eggs, within a few months after surgery.
Patients with gallstones can be examined and treated at Vinmec International General Hospital. Here, patients will be examined and consulted by highly qualified and experienced experts and doctors. Depending on the case, the doctor will appoint the patient to take medicine or perform laparoscopic cholecystectomy. Laparoscopic cholecystectomy at Vinmec is carried out according to strict procedures, using modern medical equipment, the incision will be bio-glued to minimize surgical scarring. After surgery, patients will have adequate and proper pain control to help patients feel absolutely no pain, be cared for in comfortable, fully functional wards, help patients recover quickly.