Intro – Did you know that only 10% of all stones in the gallbladder develop symptoms in the first 5 years?
Gallbladder stones are being detected routinely and its incidence of detection is increasing per day because it is easily detected on Ultrasound.
An asymptomatic gallstones is that stone that is incidentally detected on ultrasound however it is not causing any problem to the patient.
The symptoms of gallstones are pain below the right rib cage and epigastric pain (pain in midline between rib cage) radiating to back. It is not relieved by antacids or change of position or passing of gases.
It is an evidence based fact that out of all gallstones, only 10% develop symptoms in first 5 years, 20% develop symptoms in next 20 years. i.e. it remains asymptomatic or develops no symptoms even in late stages of life.
Life threatening complaints never happen until the patient has had episodes of earlier pain.
Increased risk of asymptomatic patient of gallbladder calculus becoming symptomatic is if the age is more than 55 years or less than 25 years. If he is smoker, female sex, has greater body weight with BMI >30.
If the size of the calculus is less than 3mm, or is more than 2cm the chances of patient changing from asymptomatic into symptomatic increase further. Another risk factor is if the calculi are freely floating the chances of complications further enhance.
Chances of gallbladder calculus changing into gallbladder cancer are very low worldwide. However, the incidence of cancer formation in gallbladder varies with genetics and environmental factors. It is most prevalent in India, Pakistan, Korea, Japan and East Europe. In India itself, Delhi is most susceptible for gall stone patients turns into gallbladder cancer.
Hence if you are a young female living in Delhi with obesity and multiple and multiple calculi, you are susceptible to develop cancer. Hence, should get the asymptomatic gallbladder removal. If you are not planning to get it removed then a 6 monthly follow up is needed along with weight reduction and changes in dietary habits.