(When to consult a doctor for the gallstone "report")

In whatever meagre experience I have over online consultation, there is one question which I have found to be too concerning and confusing to the patient. I have come across 30-40 questions over this in less than a month to be specific. Such is the burden of the confusion.

The fact that we have been inclined towards the western type of diet and te lifestyle changes that we have undergone will further increase the incidence of this disease and the confusion that the patients have .

Is there any article that will clear this confusion once and for all?

Here is an attempt to help you out.

1) " Treat the patient and not the reports".  

The stalwarts in surgery and even the books have always quoted this one statement that itself will clear the most common question that the patients have. 

SHOULD I GET OPERATED FOR THE POSITIVE GALLSTONE REPORT?

The answer is a big "NO"

Numerous patients get a 'routine check up' done and find out that they have gallstone or gall bladder sludge. 

Here is where the quote mentioned above comes into picture.

The gallstone seen here is just an incidental finding...i e the patients have no symptoms related to gallstone

This brings us to the main question and where this entire discussion funnels down to . What exactly are the symptoms of gall stones which mandate an operative intervention?

a) post prandial pain in the right hypochondrium or the epigastrium , sometimes in the region of the right scapula ( shoulder blade ) 

Quadrants of abdomen

b) previous history suggestive of acute or chronic cholelithiasis.

When to operate when the patient doesn't have symptoms of gallstones?

c) if the patient is immunocompromised ( on drugs causing immunosuppression or is a patient of HIV )

d) if he is undergoing a bariatric surgery

e) if the report says procelain ( calcified gall bladder )

f) if the report says that the gall stone is larger than 2.5 cm.

g) if the report shoes multiple gall bladder polyps or a single polyp larger than 1 cm.

h) if the patient has undergone ERCP or MRCP and the report says that there is a long common channel of biliary and pancreatic ducts

If the report shows any of these or only if the patients have symptoms , then and only then is there any need to consult a surgeon and to get operated. Otherwise there is no need to do so.