Surgery for gallstones that do not cause symptoms

Experts disagree about whether the gallbladder should be removed for gallstones that do not cause symptoms. Surgery may be needed if you:¹

• Have a very large gallstone.
• Have a condition called porcelain gallbladder (calcified wall), which may increase the risk of gallbladder cancer.
• Have sickle cell disease. Symptoms of gallstones can resemble those of sickle cell crisis, and people who have sickle cell disease are likely to form gallstones.
• Are a Pima Indian. Pima Indians who have gallstones may have a higher risk of gallbladder cancer.
• Plan to have an organ transplant (such as a heart or kidney).

Doctors sometimes recommend surgery for women who are trying to become pregnant. This may be true for a woman who has had symptoms in the past that are believed to be caused by gallstones, and the woman and her health professional are concerned that her symptoms may get worse during pregnancy. They may choose to do surgery to prevent any possible complications, especially if the woman's pregnancy is likely to be high-risk because of other problems.

Some doctors may recommend gallbladder surgery if a person is waiting for an organ transplant or is taking immunosuppressive medicines after receiving a transplanted organ.

Most doctors do not recommend that people with diabetes have surgery for gallstones that do not cause symptoms. The risk of surgery in people who have diabetes may be higher than the risk of a gallstone attack. Surgery is recommended after the first occurrence of symptoms.

Citations

1. Huang CS, Lichtenstein DR (2006). Biliary tract stones. In MM Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 395–408. Philadelphia: Saunders Elsevier.