What happens if gallstones are not treated with surgery?

In general, patients with cholelithiasis who do not undergo surgery may experience recurrent biliary colic, frequent episodes of cholecystitis, biliary tract obstruction, biliary pancreatitis, and an increased risk of gallbladder cancer. The specific impacts vary depending on the size and location of the stones, as well as the patient's overall health. Detailed analysis is as follows:

1. Recurrent biliary colic: Stones may move within the gallbladder and block the cystic duct or bile duct opening, triggering biliary colic. Pain is typically located in the right upper abdomen and presents as paroxysmal, severe pain, often accompanied by nausea and vomiting. Symptoms are easily triggered after consuming fatty foods.

2. Frequent cholecystitis attacks: Long-term irritation of the gallbladder wall by stones, or obstruction of the cystic duct leading to bile stasis, can easily cause cholecystitis. During acute episodes, symptoms include abdominal pain, fever, and tenderness in the gallbladder area. Chronic cases present as dull pain in the right upper abdomen and bloating. Repeated episodes over time lead to thickening of the gallbladder wall and gradual decline in gallbladder function.

3. Biliary tract obstruction: If a stone dislodges from the gallbladder and enters the bile duct, it may obstruct the duct, preventing normal bile drainage. This results in jaundice (yellowing of the skin and eyes), darkened urine, pale stools, and is often accompanied by abdominal pain and fever.

4. Biliary pancreatitis: Stones in the bile duct that block the opening of the pancreatic duct can prevent normal drainage of pancreatic juice, leading to biliary pancreatitis. Patients experience severe upper abdominal pain that may radiate to the back, along with nausea, vomiting, and fever. In severe cases, shock may occur, causing serious damage to the digestive system.

5. Increased risk of gallbladder cancer: Long-standing gallstones continuously irritate the gallbladder mucosa, leading to mucosal hyperplasia and atypical hyperplasia, which gradually increase the risk of developing gallbladder cancer. Early symptoms of gallbladder cancer are often subtle; when diagnosed, the disease is frequently already in its middle or late stages, resulting in poor treatment outcomes and a grim prognosis.

It is recommended that patients with cholelithiasis have regular follow-up examinations to monitor stone size and gallbladder condition. They should also avoid consuming excessive oily or high-fat foods in daily life to reduce triggers for disease flare-ups.