Do I need surgery if gallstones are found during a physical examination

Whether surgery is necessary for gallstones discovered during physical examination depends on the size of the stones, symptoms, and risk of complications. Most asymptomatic small stones do not require immediate surgery, but surgery is usually recommended in cases of recurrent biliary colic, cholecystitis, or high-risk factors. When the diameter of gallstones is less than 10 millimeters and there are no clinical symptoms, conservative observation can be prioritized. The probability of acute cholecystitis or bile duct obstruction caused by these types of stones is low, and changes can be monitored through regular ultrasound follow-up. Daily intake of high-fat diet should be reduced to avoid overeating and inducing biliary colic. If there is a slight feeling of upper abdominal distension, oral administration of choleretic drugs such as ursodeoxycholic acid capsules can be tried to assist in stone dissolution, but the effect needs to be evaluated every 3-6 months. When the diameter of the stone exceeds 15 millimeters or is accompanied by thickening of the gallbladder wall and loss of gallbladder function, laparoscopic cholecystectomy is the preferred option. This type of stone can easily cause blockage of the gallbladder duct, leading to suppurative cholecystitis and even perforation. Patients with basic diseases such as diabetes and cirrhosis need more active surgery because of higher risk of infection. For patients with recurrent upper right abdominal pain or those who have previously developed pancreatitis due to stones, surgical treatment should be considered even if the stones are small. After surgery, it is necessary to maintain a low-fat diet for 2-3 months and gradually increase the intake of dietary fiber. Avoid vigorous exercise during the recovery period to prevent the formation of incisional hernia, but get out of bed and move around as early as possible to prevent venous thrombosis. Regular follow-up liver and gallbladder ultrasound confirms that there are no residual stones in the common bile duct. If jaundice or clay like stool occurs, be alert to biliary obstruction.