Do gallstones require minimally invasive surgery?

Whether minimally invasive surgery is necessary for gallstones needs to be comprehensively evaluated based on the size of the stones, symptoms, and risk of complications. Most asymptomatic small stones may not require surgery temporarily. Laparoscopic cholecystectomy is recommended when recurrent biliary colic, cholecystitis, or when there is a risk of cancer. When the diameter of gallstones is less than 10 millimeters and there are no clinical symptoms, immediate surgical intervention is usually not necessary. Management can be achieved through regular ultrasound monitoring, low-fat diet, and avoiding overeating. Patients of this type can be followed up 1-2 times a year for examination. If there is hidden pain in the upper right abdomen, they can follow the doctor's advice to use choleretic drugs such as ursodeoxycholic acid capsules. However, caution should be exercised that stones may enter the common bile duct with bile flow, leading to cholangitis or pancreatitis. In such cases, endoscopic stone removal treatment should be combined.

Minimally invasive surgery is more necessary for gallstones over 15mm or full gallstones, especially when diabetes, gallbladder wall thickening and other risk factors are combined. Laparoscopic cholecystectomy has the advantages of minimal trauma and fast recovery, and can be discharged 1-3 days after surgery. But for those with severe adhesion between the gallbladder and surrounding tissues, coagulation dysfunction, or cardiopulmonary dysfunction, it is necessary to evaluate the possibility of conversion to open surgery. postoperative sequelae such as diarrhea and indigestion may occur, which can usually resolve on their own after 3-6 months. After surgery, it is recommended to maintain a light diet, gradually increase dietary fiber intake, and avoid fried foods and animal organs. Regular eating helps with bile excretion and reduces the risk of common bile duct stones formation. Follow up liver function and abdominal ultrasound one month after surgery. If there is persistent fever, jaundice, or severe abdominal pain, seek medical attention immediately. During long-term follow-up, attention should be paid to compensatory dilation of the bile duct, and if necessary, magnetic resonance cholangiopancreatography evaluation should be performed.