Do gallstones require minimally invasive surgery?

Whether minimally invasive surgery is needed for gallstones depends on the size of the stones, symptoms, and complications. Most asymptomatic small stones can be observed conservatively, and minimally invasive surgery is usually recommended for recurrent biliary colic or concurrent cholecystitis, bile duct obstruction, and other conditions. When the diameter of gallstones is less than 10 millimeters and there are no symptoms such as abdominal pain or fever, regular ultrasound monitoring and low-fat diet management can be used. These patients may have long-term stable stones, and surgical intervention is not necessary. If chronic cholecystitis is combined but does not occur frequently, medication such as ursodeoxycholic acid capsules can be tried for stone dissolution treatment, combined with a light diet to reduce bile secretion stimulation. When the diameter of the stone exceeds 15 millimeters or causes acute cholecystitis or biliary pancreatitis, laparoscopic cholecystectomy is the preferred option. Minimally invasive surgery is performed through 3-4 small incisions in the abdomen, which has the advantages of minimal trauma and fast recovery. If a stone falls into the common bile duct and causes jaundice, it may be necessary to combine endoscopic retrograde cholangiopancreatography to remove the stone. When there is gallbladder atrophy, porcelain gallbladder or suspected cancer, surgical resection is recommended even if there are no symptoms. After surgery, it is necessary to maintain a low-fat diet for 3-6 months and gradually increase the intake of high-quality protein and dietary fiber. Avoid vigorous exercise for one month to prevent increased abdominal pressure, fever, and persistent abdominal pain. Timely follow-up is necessary. Asymptomatic stone patients should undergo liver and gallbladder ultrasound examination every year to monitor the dynamic changes of stones.