Do you still take conservative treatment for “asymptomatic” gallbladder stones?

  The presence of stones in the gallbladder without symptoms is medically known as “resting stones”. In recent years, due to the widespread use of ultrasound, such patients are often seen during medical examinations. Gallbladder stones are usually caused by over-nutrition and the deposition of cholesterol in the gallbladder in excess of the body’s normal needs.  There are two ways of looking at static gallbladder stones: one is that they are asymptomatic for a long time, their natural process is benign and they can coexist peacefully without surgery; the other is that although static stones are asymptomatic at present, they cannot be taken lightly, they do not remain static forever, they are like a time bomb buried in the body and are in danger of exploding at any time, so it is better to treat them early. If not treated, stones can move and rub in the gallbladder, causing inflammation of the gallbladder wall; stones can block the gallbladder duct, causing severe biliary colic or fluid in the gallbladder; acute cholangitis can lead to gallbladder necrosis and perforation; small stones can enter the common bile duct from the gallbladder duct, eventually leading to obstructive jaundice and purulent cholangitis; in a few patients, the long-term stimulation of stones can cause gallbladder cancer.  How great is the danger of all the above? According to statistics, about 25% of asymptomatic gallbladder stone patients develop symptoms within 10 years. Some people have observed 781 patients with asymptomatic gallbladder stones for 11 years, 49% were asymptomatic, 33% had severe symptoms, 18% developed complications, 173 of them underwent surgery, and 1.7% died. These data show that gallbladder stones are not always peaceful, so they should not be taken lightly.  In addition, we should pay more attention to the fact that asymptomatic gallbladder stones may lead to serious complications such as gallbladder cancer, which is called “accidental gallbladder cancer”, because the prognosis of gallbladder cancer is very poor, with a 5-year survival rate of less than 15%.  Simply put, weighing the pros and cons is the common principle to decide whether to operate or not. Before the development of lumpectomy technology, cholecystectomy required open abdominal procedures, which were traumatic and had many postoperative complications, which was one of the reasons why older generations of physicians were opposed to asymptomatic gallbladder stone surgery. Nowadays, the development of laparoscopic cholecystectomy technology, and even the maturity of single- and double-port laparoscopic technology, has reduced the trauma of cholecystectomy to the least and the postoperative complications to the lowest, removing this “time bomb” from the body at the lowest cost, why not!