Gallbladder stones, or gallstones, are a common condition that can sometimes cause pain, digestive issues, or complications—but not all of them require surgery. Many people live with gallstones without ever experiencing symptoms.
A common question patients ask is: what size of gallbladder stones need surgery? In general, treatment is unnecessary if the stones do not cause symptoms. However, when gallstones trigger pain, indigestion, or complications such as infection or bile duct obstruction, gallbladder removal surgery is often recommended.
This guide explains when gallstones become a concern and how factors like size, symptoms, and individual risk profile influence decisions about gallstones treatment in Singapore.
What Are Gallstones and How Do They Form?
Gallstones are hardened deposits of bile that develop in the gallbladder, a small organ beneath the liver that stores and releases bile to aid digestion. They can form when bile contains too much cholesterol, bilirubin, or when the gallbladder does not empty efficiently.
The size of gallstones can range from a tiny grain of sand to several centimetres across, with some people forming just one stone and others developing multiple stones at once. While many remain asymptomatic, others may experience pain or complications that require gallstones surgery.
Size of Gallstone: Does It Really Matter?
The size of a gallstone can affect treatment decisions, but it is not the only factor doctors consider. Even small stones may cause severe symptoms if they enter and block the bile ducts. Larger stones—typically more than 2-3 cm—are associated with impaired gallbladder function, recurrent inflammation, or, in rare cases, an increased risk of gallbladder cancer.
What Size of Gallstones Typically Need Surgery?
Gallstones larger than 2 cm are generally more likely to require surgical removal, even if they do not yet cause symptoms, because of their higher risk of complications. However, stones of any size may warrant surgery if they cause:
- Recurrent abdominal pain (biliary colic)
- Gallbladder inflammation (cholecystitis)
- Obstruction of the bile ducts
- Jaundice or pancreatitis
Symptoms That Suggest It’s Time to Consider Gallbladder Surgery
Not all gallstones require surgical removal, and the need for gallstones surgery depends on both the size of the stones and the presence of symptoms.
Asymptomatic Gallstones
Many individuals carry gallstones without any noticeable symptoms. These are often discovered incidentally during imaging for unrelated reasons. In such cases, surgery is typically not necessary, though periodic monitoring may be advised.
Symptomatic Gallstones
Surgery is usually recommended when gallstones lead to significant symptoms, which can include:
- Sharp or intense upper right abdominal pain: Known as biliary colic, this pain can last from minutes to hours and may radiate to the back or shoulder
- Nausea or vomiting: Often occurs alongside pain, indicating a blockage caused by a gallstone.
- Indigestion or bloating: A sense of fullness, especially after fatty meals.
- Jaundice: Yellowing of the skin or eyes, caused by bile buildup when a gallstone obstructs the bile duct.
Ultimately, the decision to proceed with surgery considers both the size of the gallstone and the patient’s symptoms, overall health, and risk profile. Consulting a gallbladder specialist or healthcare professional ensures a personalised assessment and the most appropriate treatment plan.
How Gallstones Are Diagnosed and Evaluated
Accurate diagnosis is essential for determining the appropriate gallstones treatment in Singapore. Several tools and tests are used to evaluate gallstones:
- Ultrasound: The primary imaging technique for detecting gallstones. It is non-invasive and highly effective at identifying stones within the gallbladder.
- Computed Tomography Scan (CT Scan): Provides detailed images of the abdominal area, helping to diagnose complications or rule out other causes of abdominal pain.
- Magnetic Resonance Cholangiopancreatography (MRCP): A specialised MRI technique that visualises the bile ducts and pancreatic system, offering valuable insights for diagnosing gallstones or related conditions.
- Endoscopic Ultrasound (EUS): EUS combines endoscopy and ultrasound to provide detailed images of the digestive tract and surrounding organs, aiding specialists in detecting gallstones and potential complications.
- Blood Tests: Blood tests assess liver function and detect signs of inflammation or infection, providing crucial indicators that support an accurate diagnosis.
Treatment Options: Watchful Waiting vs Surgery
The choice of gallstones treatment in Singapore depends on symptoms, stone size, and overall health:
- Watchful Waiting: For asymptomatic gallstones, monitoring is often sufficient, with surgery considered only if symptoms develop.
- Medications: Drugs like ursodeoxycholic acid may slowly dissolve small cholesterol stones, but effectiveness is limited and recurrence is possible.
- Non-Surgical Procedures: Techniques such as Endoscopic Retrograde Cholangiopancreatography (ERCP) can remove stones from the bile ducts when necessary.
- Surgery: Laparoscopic cholecystectomy is the standard, minimally invasive approach for symptomatic or large stones. Open cholecystectomy is reserved for complex cases.
Why It’s Important to Speak to a Gallstone Specialist
While gallstones cannot always be prevented, adopting healthy lifestyle habits may help lower the risk of developing them:
- Maintain a healthy weight with regular exercise and a balanced diet
- Eat more high-fibre foods and healthy fats while limiting refined carbs and sugar
- Lose weight gradually if overweight or obese
That said, every patient’s condition is different. Age, coexisting health issues, and gallbladder function all play a role in determining the most suitable treatment plan. Consulting an experienced healthcare professional and doctor ensures that your situation is evaluated thoroughly and appropriately.
As a highly experienced gallbladder inflammation specialist and surgeon, Dr. Thng Yongxian provides precise assessments and expert guidance on whether surgery is necessary. He tailors each recommendation to your unique condition, helping you make informed decisions about your health.
If you are seeking gallstones treatment in Singapore, don’t leave things to chance — book a consultation with Dr. Thng for a personalised evaluation and treatment plan.